Incidence of and risk factors for surgical site infections in women undergoing hysterectomy for endometrial carcinoma

Tuomi, Taru; Pasanen, Annukka; Leminen, Arto; Bützow, Ralf; Loukovaara, Mikko

doi:10.1111/aogs.12838

Cited by 13 publications

(13 citation statements)

References 21 publications

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“…With respect to wound infections, our appendectomy data are consistent with two smaller prior studies showing increased infectious complications in obese children[18, 19], as well as with extensive data in adults[5-14]. More careful consideration of appropriate antibiotic prophylaxis is warranted, particularly given that dosing may be different in obese children.…”

Section: 4 Discussionsupporting

confidence: 87%

“…Obese adults are at higher risk for aspiration due to elevated gastric residual volumes, and drug distributions may be more difficult to predict[5]. From a surgical perspective, studies have consistently shown an increase in wound complications including infections in multiple types of non-bariatric abdominal surgeries [5-14]. Data regarding other complications are more controversial: some studies have shown obesity to be associated with wound dehiscence[15, 16] and other nosocomial infections[5, 17], while others have not shown obesity to be a risk factor for other major perioperative complications[7, 9, 10].…”

Section: 1 Backgroundmentioning

confidence: 99%

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Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Witt

Goldin

Vavilala

et al. 2016

Journal of Pediatric Surgery

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Background/Purpose Pediatric obesity is an important public health concern, yet its effect on surgical outcomes is poorly understood. The purpose of this study was to determine if age and gender-specific body mass index (BMI) percentile influences complications and hospital resource utilization following pediatric gastrointestinal surgeries. Methods Patients aged age ≥2 to <18 years who underwent appendectomy or other gastrointestinal operations were identified in the 2012 - 2013 Pediatric National Surgical Quality Improvement Program datasets. Age- and gender-specific pediatric BMI percentiles were calculated. Patients who underwent appendectomy (n=9,606) and those undergoing all other intestinal operations (n=2,664) were evaluated as separate cohorts. Results In the appendectomy cohort, frequency of any complication increased with BMI category (normal-weight 4.5%, overweight 5.3%, obese 5.7%, morbidly obese 7.3%, overall 5.0%, p = 0.014). In multivariable analysis, there was a quadratic association between BMI percentile and increased frequency of superficial incisional infection, unplanned tracheal intubation, and longer operative duration. In the intestinal surgery cohort, BMI percentile was not a predictor of any individual complication or any measure of hospital utilization. Conclusions Age- and gender-specific BMI percentile was associated with increased risk of complications and longer operative duration in patients undergoing appendectomy but not other intestinal operations.

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Section: 4 Discussionsupporting

confidence: 87%

Section: 1 Backgroundmentioning

confidence: 99%

Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Witt

Goldin

Vavilala

et al. 2016

Journal of Pediatric Surgery

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“…This finding is in agreement with previous study in Cameron (10), India (14), Nepal (12) and India (15) In present study, patients who had history of surgical procedures were about three times more likely to develop SSIs compared with patients who had no previous exposure for surgical procedure/s which was in line with other study in Ethiopia (9) in which patients who had history of surgical procedures were 3.64 times more likely to develop SSIs and Brazil (16). We also found prolonged operation is risk factor for SSIs which also in line with previous reports (14), India(4), Rwanda (17), Brazil (11), Indonesia (18) and Finland (19)in which procedures that lasts more than 2 hours prone to develop SSI.…”

Section: Discussionsupporting

confidence: 92%

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

Kebede¹,

Asredaw²

2019

Preprint

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Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.

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“…The incidence of SSI in patients with endometrial carcinoma in this present study is higher than the results of SSI of patients with non-malignant tumor operation in previous studies [ 23 , 24 ], indicating that patients with endometrial carcinomas have higher risk of SSI, which may be related to that malignant tumors can disrupt the patient’s immune system and reduce anti-infection ability [ 25 , 26 ]. Besides, 46 strains of pathogenic bacteria were isolated from patients with SSI, which are mainly gram-negative bacteria, among which Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were more common.…”

Section: Discussioncontrasting

confidence: 65%

Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

Shi

Zhang

et al. 2021

BMC Surg

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Background Surgical site infection (SSI) is a common postoperative complication. We aimed to analyze the potential risk factors of SSI in patients with endometrial carcinoma. Methods Patients with endometrial carcinoma who underwent surgery treatment in our hospital from Sept 1, 2018 to August 31, 2020 were included. We retrospectively compared the characteristics of SSI and no SSI patients, and logistic regression analyses were performed to identify the risk factors of SSI in patients with endometrial carcinoma. Results A total of 318 postoperative patients with endometrial carcinoma were included. The incidence of SSI in patients with endometrial carcinoma was 14.47 %. There were significant differences on the FIGO stage, type of surgery, durations of drainage, postoperative serum albumin and postoperative blood sugar (all p < 0.05), and no significant differences on the age, BMI, hypertension, diabetes, hyperlipidemia, estimated blood loss, length of hospital stay were found (all p > 0.05). FIGO stage IV (HR3.405, 95 %CI 2.132–5.625), open surgery (HR2.692, 95 %CI 1.178–3.454), durations of drainage ≥ 7 d (HR2.414,95 %CI 1.125–2.392), postoperative serum albumin < 30 g/L (HR1.912,95 %CI 1.263–2.903), postoperative blood sugar ≥ 10 mmol/L (HR1.774,95 %CI 1.102–2.534) were the independent risk factors of SSI in patients with endometrial carcinoma (all p < 0.05). Conclusions Measures including reasonable control of serum albumin and blood glucose levels, minimally invasive surgery as much as possible, timely assessment of drainage and early removal of the tube may be beneficial to reduce the postoperative SSI in in patients with endometrial carcinoma.

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Incidence of and risk factors for surgical site infections in women undergoing hysterectomy for endometrial carcinoma

Abstract: Organ/space infections comprised the majority of surgical site infections. Risk factors for incisional and organ/space infections differed. Minimally invasive hysterectomy was associated with a smaller risk of incisional infections but not of organ/space infections.

Cited by 13 publications

References 21 publications

Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

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