Surgical site infection (SSI) after colorectal surgery can result in complications and death. Dr Reipang Tang and colleagues in Linkou, Taiwan, determined risk factors for SSIs in patients undergoing colorectal surgery at a single institution between February 1995 and December 1998.
Surgical site infections were classified as being incisional, organ/space, or without clinical leakage.
Surgical site infections occurred after 4.7% of all operations.
Incisional, organ /space, and clinical leakage infection rates were 3.0%, 2.0%, and 0.8% respectively.
The research team used linear regression models to estimate risk factors for SSIs.
Risk factors included an American Society of Anesthesiology (ASA) score of 2 or 3 (odds ratio = 1.7), male gender (odds ratio = 1.5), a contaminated wound (odds ratio = 2.9), and creation of an ostomy (odds ratio = 2.1).
|4.7% of patients undergoing colorectal resection contract a surgical site infection.
|Annals of Surgery|
The likelihood of infection varied according to the surgeon (odds ratios = 1.3-3.3) and type of operation (odds ratios = 0.3-2.1).
Patients needing blood transfusion during surgery were more likely to get infections. Odds ratios were reported as 5.3 for patients receiving 1-3 units of blood, and 6.2 for 4 or more units of blood.
Risk factors varied in importance according to the site of infection. Only blood transfusion was consistently associated with SSIs at any given infection site.
The risk of contracting an infection during colorectal surgery seems to vary considerably according to the circumstances of the operation.
Dr Tang believes, "Determining risk factors for SSI may provide information on reducing complications and improving outcome."