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Risk factors for surgical site infection and infliximab given during surgery for Crohn’s

A study in the most recent issue of the Diseases of the Colon & Rectum identifies risk factors for surgical site infection and the association with infliximab administration during surgery for Crohn’s disease.

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Preoperative infliximab treatment may influence postoperative infectious complications in patients with Crohn’s disease.

Dr Motoi Uchino and colleagues identified predictors of surgical site infection after surgery for Crohn’s disease and evaluate the effects of preoperative infliximab administration.

The researchers performed a prospective surveillance, and review of surgical site infections.

The team conducted the study in the Surgical Department of Hyogo College of Medicine.

20% of patients received infliximab
Diseases of the Colon & Rectum

A total of 405 consecutive patients with Crohn’s disease who underwent abdominal surgery between 2008 and 2011 were included.

Infection was diagnosed by the infection control team.

The team analyzed possible risk factors by using logistic regression analyses to determine their predictive significance.

Within the patient population, 20% of patients received infliximab, and 60% had penetrating disease.

The median duration from the last infliximab infusion to surgery was 43 days.

The researchers found that the overall incidence of surgical site infection was 27%.

The incidence of incisional surgical site infection was 18%, and the organ/space surgical site infection rate was 8%.

In the multivariate analysis, the team found that proctectomy was the highest risk factor for all surgical site infection.

The research team found that administration of preoperative infliximab was not a risk factor for surgical site infection.

By contrast, there was a significantly reduced risk of incisional surgical site infection in patients with penetrating disease who received infliximab.

Dr Uchino's team commented, "Proctectomy was a high-risk factor for surgical site infection in patients with Crohn’s disease."

"The administration of preoperative infliximab was not a risk factor for surgical site infection."

Dis Colon Rectum 2013: 56(10): 1156–1165
21 October 2013

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