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Anaesthesia
An in-hospital workup of a 78-year-old hypeensive, mildly asthmatic man who is receiving chemotherapy for colon cancer reveals symptomatic gallstones. Preoperative laboratory results are notable for a hematocrit of 24% and urinalysis with 18 to 25 WBCs and gram-negative bacteria. On call to the operating room, the patient receives intravenous penicillin. His abdomen is shaved in the operating room. An open cholecystectomy is performed and, despite a lack of indications, the common bile duct is explored. The wound is closed primarily with a Penrose drain exiting a separate stab wound. On postoperative day 3, the patient develops a wound infection. Which of the following changes in the care of this patient could have decreased the chance of a postoperative wound infection?
Increasing the length of the preoperative hospital stay to prophylactically treat the asthma with steroids
Treating the urinary infection prior to surgery
Shaving the abdomen the night prior to surgery
Continuing the prophylactic antibiotics for 3 postoperative days
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