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 19 January 2018

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News

Wound infection after elective colorectal resection

The incidence of incisional surgical site infection in patients undergoing elective colorectal resection is higher than generally reported in the literature, find investigators in the May issue of the Annals of Surgery.

News image

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Surgical site infection (SSI) is a potentially morbid and costly complication following major colorectal resection.

In this study, investigators from the United States evaluated data on all elective colorectal resections performed by a single surgeon, over a 2 year period.

The team recorded all diagnoses of incisional SSI, as defined by the Center of Disease Control and Prevention.

The team also evaluated all variables associated with infection.

Overall, 176 patients who underwent elective colorectal resection were identified for evaluation.

Preoperative diagnoses included colorectal cancer (57%), inflammatory bowel disease (20%), diverticulitis (10%), and benign polyp disease (5%).

The team found that SSIs were identified in 26% of patients. Almost half of these infections were detected in the outpatient setting following discharge.
Surgical site infections were identified in 26% of patients.
Annals of Surgery

The investigators found that increasing patient body mass index and intraoperative hypotension independently predicted incisional SSI.

They calculated that a representative population of patients with SSI accumulated a mean of $6200 per patient of home health expenses related to wound care.

Overall, the team found that the rates of SSI were substantially higher than those reported in the literature.

Dr Robert Smith and colleagues concluded, "The incidence of incisional SSI in patients undergoing elective colorectal resection…substantially higher than generally reported in the literature".

"We believe these discrepancies highlight the potential limitations of systematic outcomes measurement tools which are independent of the primary clinical care team".

"Accurate surgical complication documentation by the primary clinical team is critical to identify the true frequency and etiology of surgical complications".

Ann Surg 2004; 239(5): 599-607
15 April 2004

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