Post-Laparotomy Fluid Monitoring Using Point-of-Care Ultrasound to Predict Surgical Site Infection and Improve Recovery

What this Trial Is About

Researchers are evaluating whether point-of-care ultrasound (POCUS) can detect early fluid build-up under the skin after open abdominal surgery (laparotomy) and if these findings can predict surgical site infections (SSI). The study focuses on adults who recently underwent emergency or planned open abdominal surgery. It also examines whether combining POCUS with the ASEPSIS wound scoring system improves the accuracy of SSI detection compared to either method alone. This observational study aims to enhance early diagnosis and improve care after surgery. Participants will receive a single wound swab between days 1 and 3 after surgery for microbiological analysis. They will undergo three standardized ultrasound scans of their surgical wound on postoperative days 1-3, 4-6, and 7-9. Each scan will be accompanied by wound assessments using the ASEPSIS scoring system and standardized wound photography. The ultrasound is non-invasive, using a sterile technique, and is performed with the patient lying down. The study emphasizes consistency and training to ensure reliable ultrasound evaluations across different investigators. During the study, wounds will be checked for signs of infection such as redness, swelling, tenderness, or discharge before each scan. Participants will be followed up at 7 and 30 days after surgery, and up to 90 days if they have implanted mesh, to monitor infection development and hospital readmissions. Data will be collected in a secure database, including demographic, clinical, and microbiological information. The main outcome measured is the incidence of SSI within 30 days after surgery, stratified by ultrasound findings of subcutaneous fluid. The study plans to enroll about 100 patients to ensure enough data for analysis.

The Spotlight Study: Early Identification of Post-Surgical Infections Using Bedside Ultrasound.