PURPOSE: An incisional surgical site infection (I-SSI) is a frequently observed complication following colorectal surgery. Intraoperative wound management is one of the most important factors that determine the incidence of postoperative I-SSI. The purpose of this study was to assess the impact of the methods used for intraoperative wound management on the incidence of I-SSI following elective surgery for colorectal cancer. METHODS: Between November 2009 and February 2011, the data of 1,980 consecutive patients who underwent elective colorectal resection for colorectal cancer were prospectively collected from 19 affiliated hospitals. The incidence of and risk factors for I-SSI were investigated. RESULTS: Overall, 233 I-SSIs were identified (11.7 %). Forty-two possible risk factors were analyzed. Using a multivariate analysis, the independent risk factors for I-SSI were identified to be a high body mass index, previous laparotomy, chronic liver disease, wound length, contaminated wound class, creation or closure of an ostomy, right hemicolectomy procedure, the suture material used for fascial closure and the incidence of organ/space SSI. CONCLUSION: To prevent I-SSI following elective colorectal surgery, it is crucial to avoid making large incisions and reduce fecal contamination whenever possible. A high quality randomized control trial is necessary to confirm the definitive intraoperative procedure(s) that can minimize the incidence of I-SSI.
PURPOSE: An incisional surgical site infection (I-SSI) is a frequently observed complication following colorectal surgery. Intraoperative wound management is one of the most important factors that determine the incidence of postoperative I-SSI. The purpose of this study was to assess the impact of the methods used for intraoperative wound management on the incidence of I-SSI following elective surgery for colorectal cancer. METHODS: Between November 2009 and February 2011, the data of 1,980 consecutive patients who underwent elective colorectal resection for colorectal cancer were prospectively collected from 19 affiliated hospitals. The incidence of and risk factors for I-SSI were investigated. RESULTS: Overall, 233 I-SSIs were identified (11.7 %). Forty-two possible risk factors were analyzed. Using a multivariate analysis, the independent risk factors for I-SSI were identified to be a high body mass index, previous laparotomy, chronic liver disease, wound length, contaminated wound class, creation or closure of an ostomy, right hemicolectomy procedure, the suture material used for fascial closure and the incidence of organ/space SSI. CONCLUSION: To prevent I-SSI following elective colorectal surgery, it is crucial to avoid making large incisions and reduce fecal contamination whenever possible. A high quality randomized control trial is necessary to confirm the definitive intraoperative procedure(s) that can minimize the incidence of I-SSI.
Authors: Rishabh Sehgal; Arthur Berg; Rafael Figueroa; Lisa S Poritz; Kevin J McKenna; David B Stewart; Walter A Koltun Journal: J Am Coll Surg Date: 2010-11-30 Impact factor: 6.113
Authors: Martin Hübner; Michele Diana; Giorgio Zanetti; Marie-Christine Eisenring; Nicolas Demartines; Nicolas Troillet Journal: Arch Surg Date: 2011-07-18
Authors: Christoph Justinger; Mohammed Reza Moussavian; Christian Schlueter; Berit Kopp; Otto Kollmar; Martin Karl Schilling Journal: Surgery Date: 2009-01-25 Impact factor: 3.982
Authors: Robert L Smith; Jamie K Bohl; Shannon T McElearney; Charles M Friel; Margaret M Barclay; Robert G Sawyer; Eugene F Foley Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Jennifer Blumetti; Myda Luu; George Sarosi; Kathleen Hartless; Jackie McFarlin; Betty Parker; Sean Dineen; Sergio Huerta; Massimo Asolati; Esteban Varela; Thomas Anthony Journal: Surgery Date: 2007-11 Impact factor: 3.982