INTRODUCTION: The aim of our study was to evaluate the effect of stoma creation on deep and superficial surgical site infections after an index colorectal surgical procedure. METHODS: We designed a retrospective cohort study from the National Surgical Quality Improvement Program. We evaluated all patients who underwent colorectal surgery procedures from January 2005 to December 2009 with or without creation of a stoma and sought to identify the effect of stoma creation on deep and superficial surgical site infections. RESULTS: A total of 79,775 patients underwent colorectal procedures (laparoscopic 30.7%, open 69.3%), while 8,113 patients developed a surgical site infection (10.2%). The univariate analysis revealed that surgical site infections were much more common in patients with a stoma compared to those with no stoma (11.8% vs. 9.5%, p < 0.0001). On multivariate analysis, stoma construction during the index colorectal procedure (OR 1.3, CI 1.2 to 1.4), ASA class ≥2, smoking, and abnormal body mass index were associated with surgical site infection. CONCLUSIONS: The construction of a stoma with colorectal procedures is associated with a higher risk of surgical site infection. Although the stoma effect on surgical site infection is attenuated with laparoscopic techniques, the association remained statistically significant.
INTRODUCTION: The aim of our study was to evaluate the effect of stoma creation on deep and superficial surgical site infections after an index colorectal surgical procedure. METHODS: We designed a retrospective cohort study from the National Surgical Quality Improvement Program. We evaluated all patients who underwent colorectal surgery procedures from January 2005 to December 2009 with or without creation of a stoma and sought to identify the effect of stoma creation on deep and superficial surgical site infections. RESULTS: A total of 79,775 patients underwent colorectal procedures (laparoscopic 30.7%, open 69.3%), while 8,113 patients developed a surgical site infection (10.2%). The univariate analysis revealed that surgical site infections were much more common in patients with a stoma compared to those with no stoma (11.8% vs. 9.5%, p < 0.0001). On multivariate analysis, stoma construction during the index colorectal procedure (OR 1.3, CI 1.2 to 1.4), ASA class ≥2, smoking, and abnormal body mass index were associated with surgical site infection. CONCLUSIONS: The construction of a stoma with colorectal procedures is associated with a higher risk of surgical site infection. Although the stoma effect on surgical site infection is attenuated with laparoscopic techniques, the association remained statistically significant.
Authors: Molly M Cone; Daniel O Herzig; Brian S Diggs; Jennifer D Rea; Karin M Hardiman; Kim C Lu Journal: J Gastrointest Surg Date: 2012-03-09 Impact factor: 3.452
Authors: Angela M Ingraham; Mark E Cohen; Karl Y Bilimoria; Justin B Dimick; Karen E Richards; Mehul V Raval; Lee A Fleisher; Bruce L Hall; Clifford Y Ko Journal: J Am Coll Surg Date: 2010-12 Impact factor: 6.113
Authors: Katherine S Rowell; Florence E Turrentine; Matthew M Hutter; Shukri F Khuri; William G Henderson Journal: J Am Coll Surg Date: 2007-06 Impact factor: 6.113
Authors: S F Khuri; J Daley; W Henderson; K Hur; J Demakis; J B Aust; V Chong; P J Fabri; J O Gibbs; F Grover; K Hammermeister; G Irvin; G McDonald; E Passaro; L Phillips; F Scamman; J Spencer; J F Stremple Journal: Ann Surg Date: 1998-10 Impact factor: 12.969
Authors: Angela M Ingraham; Mark E Cohen; Karl Y Bilimoria; Joseph M Feinglass; Karen E Richards; Bruce Lee Hall; Clifford Y Ko Journal: J Am Coll Surg Date: 2009-12-24 Impact factor: 6.113
Authors: Elizabeth C Wick; Deborah B Hobson; Jennifer L Bennett; Renee Demski; Lisa Maragakis; Susan L Gearhart; Jonathan Efron; Sean M Berenholtz; Martin A Makary Journal: J Am Coll Surg Date: 2012-05-24 Impact factor: 6.113
Authors: D H Culver; T C Horan; R P Gaynes; W J Martone; W R Jarvis; T G Emori; S N Banerjee; J R Edwards; J S Tolson; T S Henderson Journal: Am J Med Date: 1991-09-16 Impact factor: 4.965