Factors predicting incisional surgical site infection in patients undergoing open radical cystectomy for bladder cancer

Abstract

Advanced patient age, thick subcutaneous fat tissue, and the absence of SCSD were significantly associated with iSSI development in bladder cancer patients who underwent ORC with intestinal urinary diversion. SCSD may be a useful procedure for iSSI prevention, especially in patients with relatively thick subcutaneous fat tissue.

Fat Thickness as a Risk Factor for Infection in Lumbar Spine Surgery

“…Surgical site infections, reported by the Centers for Disease Control and Prevention to occur in up to 8.73% of revision spine surgeries, are a relatively common complication that may be minimized with preoperative counseling and intervention as well as perioperative targeted treatment. 1,6,7,[9][10][11]16,21,22 This study showed the utility of local subcutaneous fat thickness as a simple independent risk assessment tool for surgical site infection in posterior lumbar spine surgery. In the study cohort, patients with fat thickness of more than 50 mm who underwent a lumbar spine procedure through a midline posterior approach had a 4-fold increase in the odds of surgical site infection compared with those with fat thickness of less than 50 mm.…”

“…The thickness of subcutaneous fat in the surgical region of interest may increase the difficulty and duration of the procedure and may be associated with decreased blood flow and oxygen tension. 16,23,24 Vigorous retraction of hypovascular fat tissue may lead to aseptic fat necrosis and dead space formation, increasing the risk of surgical site infection. A thick subcutaneous fat layer also may lead to longer periods of drainage and the formation of sinus tracts.…”

“…Its significance as a risk factor for surgical site infection may be the result of its correlation with subcutaneous fat thickness at the surgical site. Local subcutaneous fat thickness is a risk factor for surgical site infection in abdominal surgery, [13][14][15][16] hysterectomy, 17 stoma reversal, 18 and cervical and lumbar spine surgery. 19,20 This study investigated the hypothesis that subcutaneous fat thickness is a better indicator than body mass index of the risk of surgical site infection in lumbar spine procedures performed through a posterior midline approach and that the significance of body mass index as a risk factor for surgical site infection is the result of its correlation with subcutaneous fat thickness.…”

Deep Surgical Site Infections after Open Radical Cystectomy and Urinary Diversion Significantly Increase Hospitalisation Time and Total Treatment Costs

“…The incidence rate varies throughout the literature. Several studies, frequently conducted in Japan, report incidence rates of SSI between 18 and 33% [10][11][12][13][14][15] . However, studies with large patient numbers found substantially lower rates of wound-related complications ranging from 4 to 9% [8,16,17] .…”

Correlation between lumbar multifidus fat infiltration and lumbar postoperative infection: a retrospective case–control study

“…Excess fat tissue in the surgical region may increase the difficulty and duration of the procedure due to lack of adequate exposure of the surgical site [9]. Moreover, fat tissue has less vascularity and lower tissue oxygenation than muscle tissue [34], and the use of retractors to pull apart the paraspinal soft tissue may further decrease blood flow and oxygen tension in fat tissue [24,35,36]; this may increase the risk of tissue necrosis and dead space development following wound closure, which have been thought to contribute to the development of postoperative infections [37,38]. In addition, LMM fat infiltration has its own mechanism through which it increases the risk of SSI.…”