MIAMI —The incidence of surgical site infections after colorectal surgery could be reduced through greater awareness of risk factors, Harry van Goor, M.D., said at the joint annual meeting of the Surgical Infection Society and the Surgical Infection Society-Europe.
In a prospective, randomized, multicenter study of adults who elected colorectal resection for benign disease, 163 of the 1,701 patients (9.6%) had at least one surgical site infection (SSI), reported Dr. van Goor, a surgeon at the University Medical Center Nijmegen (the Netherlands). Of these SSIs, 66 (3.8%) were incisional infections, and 111 (6.5%) were organ/space infections. Approximately 50% of the infections in a group of 1,701 colorectal surgery patients occurred within 9 days after surgery, and 97% occurred within 24 days after surgery.
Significant independent risk factors for incisional infections included high body mass index (odds ratio of 2.6), bowel preparation with antibiotics (OR 0.5), preoperative hospitalization (OR 1.8), and wound classification (OR 2.8).
Significant independent risk factors for organ/space infections included age (OR 0.4), preexisting abscess or fistula (OR 19.1), diabetes (OR 2.4), perioperative steroid use (OR 2.1), preoperative hospitalization (OR 1.4), multiple procedures (OR 2.5), and wrapping of the antiadhesion barrier around an anastomosis (OR 3.1).
“Hospital stay increases by an average of 7 days if a surgical site infection occurs,” said Dr. van Goor. Furthermore, patients with SSIs are more likely to be admitted to the ICU than patients without infections.