Pamela Barbadoro1, Cristina Marmorale2, Claudia Recanatini3, Giorgia Mazzarini3, Ilaria Pellegrini3, Marcello M D'Errico4, Emilia Prospero4. 1. Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy; Hospital Hygiene Service, Ospedali Riuniti di Ancona, Ancona, Italy. Electronic address: p.barbadoro@univpm.it. 2. Department of Experimental and Clinical Medicine, Unit of Surgical Sciences, Università Politecnica delle Marche, Ancona, Italy; General Surgery Ward, Ospedali Riuniti di Ancona, Ancona, Italy. 3. Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy. 4. Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy; Hospital Hygiene Service, Ospedali Riuniti di Ancona, Ancona, Italy.
Abstract
BACKGROUND: Surgical site infection (SSI) is among the most frequent hospital-acquired infections occurring in surgical patients and leads to increased morbidity, mortality, and costs. We aimed to identify risk factors for SSI in patients undergoing surgical procedures, with a particular attention to the use of drains. METHODS: This study includes all patients undergoing abdominal surgical procedures in 2 surgical wards in a teaching hospital in central Italy. Collected data included patient's demographic and clinical characteristics, procedure characteristics, administration of perioperative antibiotic prophylaxis, and microorganism isolated. The outcome of interest was SSI. FINDINGS: A total of 872 abdominal surgery procedures were surveyed during the study period. Drains were placed in 37.0% of cases. SSI rate was 6.4% globally and 13.6% among the patients with drains, versus 2.4% in those without a drain (P < .001). In 72.1% of cases antibiotic prophylaxis was administered. The logistic regression analysis (P < .001) shown insertion of a drain (odds ratio [OR], 5.14; 95% confidence interval [CI], 2.63-10.08), prolonged surgery (OR, 1.98; 95% CI, 1.09-3.59), and American Society of Anesthesiologists score equal to 3 (OR, 6.13; 95% CI, 2.33-16.11) as independent risk factors for SSI, whereas antibiotic prophylaxis was protective (OR, 0.53; 95% CI, 0.29-0.99). CONCLUSION: This study revealed surgical drains as a risk factor for SSI, pointing out the need of a clearer understanding of drain role in the dynamics of SSI occurrence, with the purpose of decreasing infection risk through targeted preventive interventions.
BACKGROUND: Surgical site infection (SSI) is among the most frequent hospital-acquired infections occurring in surgical patients and leads to increased morbidity, mortality, and costs. We aimed to identify risk factors for SSI in patients undergoing surgical procedures, with a particular attention to the use of drains. METHODS: This study includes all patients undergoing abdominal surgical procedures in 2 surgical wards in a teaching hospital in central Italy. Collected data included patient's demographic and clinical characteristics, procedure characteristics, administration of perioperative antibiotic prophylaxis, and microorganism isolated. The outcome of interest was SSI. FINDINGS: A total of 872 abdominal surgery procedures were surveyed during the study period. Drains were placed in 37.0% of cases. SSI rate was 6.4% globally and 13.6% among the patients with drains, versus 2.4% in those without a drain (P < .001). In 72.1% of cases antibiotic prophylaxis was administered. The logistic regression analysis (P < .001) shown insertion of a drain (odds ratio [OR], 5.14; 95% confidence interval [CI], 2.63-10.08), prolonged surgery (OR, 1.98; 95% CI, 1.09-3.59), and American Society of Anesthesiologists score equal to 3 (OR, 6.13; 95% CI, 2.33-16.11) as independent risk factors for SSI, whereas antibiotic prophylaxis was protective (OR, 0.53; 95% CI, 0.29-0.99). CONCLUSION: This study revealed surgical drains as a risk factor for SSI, pointing out the need of a clearer understanding of drain role in the dynamics of SSI occurrence, with the purpose of decreasing infection risk through targeted preventive interventions.
Authors: Matthew L Tamplen; Jesse Tamplen; Elizabeth Shuman; Chase M Heaton; Jonathan R George; Steven J Wang; William R Ryan Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-12-01 Impact factor: 6.223
Authors: Rachel L O'Donnell; Georgios Angelopoulos; James P Beirne; Ioannis Biliatis; Helen Bolton; Melissa Bradbury; Elaine Craig; Ketan Gajjar; Michelle L Mackintosh; Wendy MacNab; Thumuluru Kavitha Madhuri; Mark McComiskey; Eva Myriokefalitaki; Claire L Newton; Nithya Ratnavelu; Sian E Taylor; Amudha Thangavelu; Sarah A Rhodes; Emma J Crosbie; Richard J Edmondson; Yee-Loi Louise Wan Journal: BMJ Open Date: 2019-01-24 Impact factor: 2.692