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Update of risk factors for surgical site infection in clean-contaminated wounds after gastroenterological surgery: An analysis of 1,878 participants enrolled in 2 recent randomized control trials for the prevention of surgical site infection.
Maemoto, Ryo; Noda, Hiroshi; Ichida, Kosuke; Fukai, Shota; Sakai, Ayano; Mizusawa, Yuki; Morita, Ryusuke; Hatsuzawa, Yuuri; Endo, Yuhei; Fukui, Taro; Takayama, Yuji; Kakizawa, Nao; Muto, Yuta; Maeda, Shimpei; Watanabe, Fumiaki; Miyakura, Yasuyuki; Rikiyama, Toshiki.
Affiliation
  • Maemoto R; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Noda H; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan. Electronic address: noda164@omiya.jichi.ac.jp.
  • Ichida K; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Fukai S; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Sakai A; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Mizusawa Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Morita R; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Hatsuzawa Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Endo Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Fukui T; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Takayama Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Kakizawa N; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Muto Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Maeda S; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Watanabe F; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Miyakura Y; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
  • Rikiyama T; Department of Surgery, Saitama Medical Center, Jichi Medical University, Japan.
Surgery ; 174(2): 283-290, 2023 08.
Article in En | MEDLINE | ID: mdl-37183131
BACKGROUND: Clean-contaminated wounds should be the main target for reducing the burden of harm caused by surgical site infection after gastroenterological surgery. METHODS: The present study targeted 1,973 patients enrolled in 2 randomized controlled trials to evaluate the efficacy of intraoperative interventions for incisional surgical site infection prevention after gastroenterological surgery with clean-contaminated wounds. Patients were reassessed, and preoperative and postoperative variables were collected. Risk factors for surgical site infection were identified by univariate and multivariate analyses. RESULTS: The study population included 1,878 patients, among whom 213 (11.3%) developed overall surgical site infection and 119 (6.3%) developed incisional surgical site infection. A multivariate analysis revealed that steroid or immunosuppressant use (odds ratio 3.03; 95% confidence interval 1.37-6.73, P = .0064), open surgery (odds ratio 1.77; 95% confidence interval 1.11-2.83, P = .0167), and long operative time (odds ratio 2.31; 95% confidence interval 1.5-3.56, P < .001) were independent risk factors for incisional surgical site infection. Steroid or immunosuppressant use (odds ratio 2.62; 95% confidence interval 1.29-5.33, P = .0078), open surgery (odds ratio 2.13; 95% confidence interval 1.44-3.16, P < .001), and long operative time (odds ratio 2.92; 95% confidence interval 2.08-4.10, P < .001) were also independent risk factors for overall surgical site infection in the multivariate analysis. Furthermore, a multivariate analysis revealed that a long operative time (odds ratio 3.21; 95% confidence interval 1.69-6.1, P = .00378) was an independent risk factor for incisional surgical site infection in patients who underwent laparoscopic surgery. CONCLUSION: Even under current measures for surgical site infection prevention, surgeons should continue to make efforts to appropriately expand the indication of laparoscopic surgery and to reduce operative times even when performing laparoscopic surgery.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Surgical Wound Infection / Wound Healing Type of study: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Surgery Year: 2023 Document type: Article Affiliation country: Japan Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Surgical Wound Infection / Wound Healing Type of study: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Surgery Year: 2023 Document type: Article Affiliation country: Japan Country of publication: United States