A multivariate analysis of the factors associated with wound infection after colorectal surgery

Abstract

Objectives Wound infection has been proposed as a key indicator of clinical outcome after colorectal surgery. The aim of this study was to identify risk factors that were associated with wound infections in patients undergoing either emergency or elective colonic resections. Patients and methods We prospectively evaluated 251 patients admitted to Royal Perth Hospital over a 12‐month period. All patients received prophylactic peri‐operative antibiotics and were reviewed for 6 weeks post‐operatively. Wound infection was defined as either the presence of pus or a serous discharge containing pathogenic bacteria. We evaluated the relationship between 40 independent variables and the incidence of wound infection. Results There were 124 males and 127 females, of median age 68 years (range 14–90 years). The overall incidence of wound infection was 12%. Multiple logistic regression identified the presence of shock (odds ratio (OR) 14.6, P=0.05), atelectasis (OR 3.9, P=0.02), and number of days on antibiotics before surgery (OR 1.2, P=0.02) as significant independent variables. Conclusion These results suggest that the factors which were most often associated with wound infection were those that are indicative of either extensive disease or poor general health. The presence of a stoma and colonic perforation were not strong independent associations with wound infection.

Anastomotic leak in colorectal surgery: A single surgeon’s experience

“…It may simply have been due to the fact that such patients already had many other comorbidities prior to surgery and that morbidity and mortality in these patients was higher. 17,18 The most important determinants of wound infection seem to be measures of patient health 18 and it seems probable that these same factors played a part in determining the rate of anastomotic dehiscence in the present study. The need for TPN and blood transfusion, indicators of patient unwellness, was common in the patients who died following leakage.…”

“…The most important determinants of wound infection seem to be measures of patient health 18 and it seems probable that these same factors played a part in determining the rate of anastomotic dehiscence in the present study. The need for TPN and blood transfusion, indicators of patient unwellness, was common in the patients who died following leakage.…”

“…It was difficult to explain why ileorectal anastomoses under such circumstances should be associated with such a high morbidity and mortality. It may simply have been due to the fact that such patients already had many other comorbidities prior to surgery and that morbidity and mortality in these patients was higher 17,18 …”

A Prospective Study on Sepsis after Emergency Abdominal Surgery

“…This is indeed a higher rate than that quoted in surgical literature at 12%. 1 Higher infection rate was observed in emergency surgery 27.5%. 3 It has been shown that over 50% of the infections occur within the first week after operation, and about 90% within two weeks.…”