Protracted Port-site Infection: A Dilemma

Objectives: From simple beginnings, laparoscopic surgery has now been completely integrated into the field of gynecological surgery. Infection of the port site is an infrequent complication of laparoscopy. The causative organisms of this infection are usually those which are most prevalent in the institute, e.g. S.aureus, E.coli. These types of infections are easily treated by the antibiotics which are most commonly prescribed in the institute. Sometimes, these port-site infections become protracted and recurrent and pose as a dilemma for the surgeons and become distressing for the patients. Materials and methods: A prospective longitudinal study was conducted on 25 patients presenting to the OPD with recurrent discharge or nonhealing port-site wound following laparoscopic surgery done in our institute. These patients underwent a battery of test including detailed microbiological examination. The discharge from their port site was sent for routine aerobic culture and sensitivity. It was also sent for Z-N stain and culture for Mycobacterium including atypical Mycobacterium. Results: Out of the 25 patients studied, 16 showed presence of AFB bacilli in their discharge and the culture for Mycobacterium showed presence of Atypical Mycobacterium in 12 cases. Out of the remaining nine patients, six showed a growth of S. aureus on aerobic culture and the remaining patients had a growth of E. coli. Conclusion: Atypical Mycobacterium is the most common causative organism of recurrent port-site infection in our institute. This type of infection then require a full course of antituberculous drugs for complete eradication. So, when treating a case of nonhealing or recurrent port-site infection, atypical Mycobacterium infection should be kept in mind.