Correlation between a positive gallbladder culture and subsequent wound infection after biliary surgery--a retrospective study of 840 patients.

The possible correlation between a positive culture of samples from the gallbladder wall and/or bile at the time of cholecystectomy and subsequent wound infections was retrospectively studied in a series of 840 patients. Positive cultures were present in 138 patients (16.4) and 19 different bacterial species could be identified. Cultured bile showed Escherichia coli in 36% of cases. The wound infection rate was 9% (72 patients) with Staphylococcus aureus cultured from the infected wounds in 64%. Fifty-eight of these 72 patients (80%) were at high risk. In contrast with the literature, no correlation existed between a positive bile culture and subsequent wound infection. In view of these results there is no need to evaluate a Gram-stain during surgery. Antimicrobial prophylaxis should be restricted to high-risk patients and the antibiotics used must be effective against exogenic wound contaminants.