Incidence of Surgical Site Infection and Risk Factors in Rectal Surgery: A Prospective Cohort Study

Colás‐Ruiz, Enrique; Del-Moral-Luque, Juan Antonio; Gil-Yonte, Pablo; Fernández‐Cebrián, José María; Alonso-García, Marcos; Villar-del-Campo, M.C.; Durán-Poveda, Manuel; Rodríguez-Caravaca, Gil

doi:10.1016/j.cireng.2018.11.012

Cited by 10 publications

(17 citation statements)

References 26 publications

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“…The meta-analysis of five studies [ 24 , 25 , 31 , 36 , 43 ] found that there was not a significant correlation between neoplasm and SSI (RR = 1.24, 95% CI: 0.58–2.26, I 2 = 81%) ( Fig 2G ).…”

Section: Resultsmentioning

confidence: 99%

Risk factors for surgical site infection in patients undergoing colorectal surgery: A meta-analysis of observational studies

Qü

Gong

et al. 2021

PLoS ONE

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Objective Surgical site infection (SSI) is the second most prevalent hospital-based infection and affects the surgical therapeutic outcomes. However, the factors of SSI are not uniform. The main purpose of this study was to understand the risk factors for the different types of SSI in patients undergoing colorectal surgery (CRS). Methods PubMed, EMBASE, and Cochrane Library databases were searched using the relevant search terms. The data extraction was independently performed by two investigators using a standardized format, following the pre-agreed criteria. Meta-analysis for the risk factors of SSI in CRS patients was carried out using Review Manager 5.3 (RevMan 5.3) and Stata 15.1 software. The quality of evidence was evaluated using total sample size, Egger’s P-value, and intergroup heterogeneity, which contained three levels: high-quality (Class I), moderate-quality (Class II/III), and low-quality (Class IV). The publication bias of the included studies was assessed using funnel plots, Begg’s test, and Egger’s test. Results Of the 2660 potentially eligible studies, a total of 31 studies (22 retrospective and 9 prospective cohort studies) were included in the final analysis. Eventually, the high-quality evidence confirmed that SSI was correlated with obesity (RR = 1.60, 95% confidence interval (CI): 1.47–1.74), ASA score ≥3 (RR = 1.34, 95% CI: 1.19–1.51), and emergent surgery (RR = 1.36, 95% CI: 1.19–1.55). The moderate-quality evidence showed the correlation of SSI with male sex (RR = 1.30, 95% CI: 1.14–1.49), diabetes mellitus (RR = 1.65, 95% CI: 1.24–2.20), inflammatory bowel disease (RR = 2.12, 95% CI: 1.24–3.61), wound classification >2 (RR = 2.65, 95% CI: 1.52–4.61), surgery duration ≥180 min (RR = 1.88, 95% CI: 1.49–2.36), cigarette smoking (RR = 1.38, 95% CI: 1.14–1.67), open surgery (RR = 1.81, 95% CI: 1.57–2.10), stoma formation (RR = 1.89, 95% CI: 1.28–2.78), and blood transfusion (RR = 2.03, 95% CI:1.34–3.06). Moderate-quality evidence suggested no association with respiratory comorbidity (RR = 2.62, 95% CI:0.84–8.13) and neoplasm (RR = 1.24, 95% CI:0.58–2.26). Meanwhile, the moderate-quality evidence showed that the obesity (RR = 1.28, 95% CI: 1.24–1.32) and blood transfusion (RR = 2.32, 95% CI: 1.26–4.29) were independent risk factors for organ/space SSI (OS-SSI). The high-quality evidence showed that no correlation of OS-SSI with ASA score ≥3 and stoma formation. Furthermore, the moderate-quality evidence showed that no association of OS-SSI with open surgery (RR = 1.37, 95% CI: 0.62–3.04). The high-quality evidence demonstrated that I-SSI was correlated with stoma formation (RR = 2.55, 95% CI: 1.87–3.47). There were some certain publication bias in 2 parameters based on asymmetric graphs, including diabetes mellitus and wound classification >2. The situation was corrected using the trim and fill method. Conclusions The understanding of these factors might make it possible to detect and treat the different types of SSI more effectively in the earlier phase and might even improve the patient’s clinical prognosis. Evidence should be continuously followed up and updated, eliminating the potential publication bias. In the future, additional high-level evidence is required to verify these findings.

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Section: Resultsmentioning

confidence: 99%

Risk factors for surgical site infection in patients undergoing colorectal surgery: A meta-analysis of observational studies

Qü

Gong

et al. 2021

PLoS ONE

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“…La principal comorbilidad en nuestro estudio fue la neoplasia, lo cual es lógico ya que se trata de una de las principales indicaciones para la cirugía de mama, y además puede contribuir a aumentar el riesgo de infección por la naturaleza de la enfermedad y el tratamiento, dificultando la curación de la herida 29 . Esta misma asociación también se describe en otras cirugías con elevada incidencia de cáncer 30 .…”

Section: Discussionunclassified

Evaluation of compliance with the antibiotic prophylaxis protocol in breast surgery and its effect on the incidence of surgical infection

Gil-Conesa¹,

Martinez²,

Luque³

et al. 2019

An Sist Sanit Navar

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artículos originales0evaluación de la adecuación al protocolo de profilaxis antibiótica en cirugía de mama y su efecto sobre la incidencia de infección quirúrgica Evaluation of compliance with the antibiotic prophylaxis protocol in breast surgery and its effect on the incidence of surgical infection , g. rodríguez caravaca 1,5 resuMen Fundamento. La profilaxis antibiótica es una de las formas más eficaces de evitar la infección de sitio quirúrgico (ISQ). En este estudio se evalúan el cumplimiento del protocolo de profilaxis antibiótica y el efecto de su inadecuación en la incidencia de ISQ en cirugía de mama.Material y métodos. Estudio prospectivo de cohortes realizado entre julio de 2008 y julio de 2018. Se evaluaron el grado de cumplimiento de la profilaxis antibiótica en cirugía de mama y las causas de no cumplimiento: elección del antibiótico, vía de administración, tiempo de inicio, dosis y duración. Se estudió la incidencia de ISQ durante los 30 días posteriores a la intervención (90 en caso de implantes o prótesis). Para evaluar el efecto de la inadecuación de la profilaxis se utilizó el riesgo relativo (RR).resultados. Se estudiaron 1.328 intervenciones en 1.212 mujeres. La incidencia acumulada de ISQ fue del 1,7% (n=22) y la etiología más frecuente Staphylococcus aureus (47,1%). El cumplimiento global del protocolo de profilaxis antibiótica fue del 95,3% (incluyendo las 568 cirugías donde no estaba indicada). Las causas principales de no cumplimiento fueron el tiempo de inicio (46,8%) y la elección del antibiótico (40,3%). La inadecuación aumentó significativamente la incidencia de ISQ (8,1 vs 1,3%, p=0,003) y el riesgo de sufrirla (RR=6,5; IC 95% 2,3-18,1).conclusiones. La tasa global de adecuación al protocolo fue muy alta. La inadecuación de la profilaxis antibiótica duplicó, al menos, el riesgo de sufrir ISQ en cirugía de mama.Palabras clave. Infección de sitio quirúrgico. Profilaxis antibiótica. Cirugía de mama. Estudio de cohortes. Vigilancia epidemiológica. aBstract Background. Antibiotic prophylaxis is one of the most effective ways to avoid surgical site infection (SSI). The present study evaluates compliance with the antibiotic prophylaxis protocol and the effect of non-compliance on the incidence of SSI in breast surgery. Methods.A prospective cohort study was carried out from July 2008 to July 2018. It assessed the degree of compliance with antibiotic prophylaxis in breast surgery and the causes of non-compliance: choice of antibiotic, route of administration, time of onset, dose and duration. The incidence of SSI was studied during the 30 days after intervention (90 in the case of implants or prostheses). Relative risk (RR) was used to assess the effect of inadequate prophylaxis.results. We studied 1,328 interventions in 1,212 women. The cumulative incidence of SSI was 1.7% (n=22) and the most common etiology was Staphylococcus aureus (47.1%). Overall antibiotic prophylaxis protocol compliance was 95.3% (including the 568 interventions where it was not indicated). The principle causes of non...

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“…Otros trabajos han mostrado la elección del antibiótico [18] o la prolongación del tiempo de administración [23][24][25] como principales causas de inadecuación de la profilaxis antibiótica en nuestro medio. En las cirugías donde no se recogió la adecuación de la profilaxis antibiótica se encontró la incidencia de ILQ más alta (11,1%), lo que nos hace sospechar que posiblemente en la mayoría de dichas intervenciones no se siguió correctamente el protocolo establecido.…”

Section: Sobre El Total De Profilaxis Administradasunclassified

“…La profilaxis antibiótica ha demostrado ser de gran utilidad en la reducción de las tasas de infección quirúrgica en diversas cirugías ginecológicas [9,11,12]. En nuestro estudio no ha resultado ser un factor con significación estadística para la reducción del riesgo, al igual que en diferentes trabajos precedentes realizados por nuestro equipo investigador en distintas localizaciones quirúrgicas [17,18,[22][23][24][25], lo que probablemente sea debido a la incidencia tan baja de ILQ en histerectomía y a la alta adecuación de la profilaxis antibiótica conseguida.…”

Section: Sobre El Total De Profilaxis Administradasunclassified

Evaluation of compliance with the antibiotic prophylaxis protocol in hysterectomy. Prospective cohort study

Gil-Conesa¹,

Del-Moral-Luque²,

Climent-Martínez³

et al. 2020

Rev Esp Quimioter

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Objectives. Health care-related infections are a public health problem, among them surgical site infection (SSI) are the most frequent in hospitals. The objetive of this study was to assess the effect of the compliance to antibiotic prophylaxis protocol on the incidence of surgical site infection in hysterectomized patients. Material and methods. A prospective cohort study was carried out between October 2009 and December 2018. The incidence of SSI was studied after a maximum period of 30 days from the moment of surgery. The degree of adequacy of antibiotic prophylaxis in hysterectomy and the effect of its inadequacy on the incidence of infection was evaluated using relative risk (RR) adjusted with a logistic regression model. Results. A total of 1,025 interventions were studied in 1,022 women. The cumulative incidence of SSI was 2,1% (n = 22). The most frequent etiology of infection was Escherichia coli (23.1%) and Proteus mirabilis (23.1%). Antibiotic prophylaxis was indicated in 1,014 interventions (98.9%) being administered in 1,009 of them (99.5%). The adherence to the protocol was 92,5%. The main cause of non-compliance was the time of onset (40.9%), followed by the choice of the antibiotic (35.2%). The effect of inadequate prophylaxis on the incidence of infection was RR = 0.9; 95% CI 0.2-3.9; p> 0.05. Conclusions. The adequacy of antibiotic prophylaxis was very high, with a low incidence of surgical site infection. No association was found between adequacy of prophylaxis and incidence of infection in hysterectomy. The continuous improvement of epidemiological surveillance in gynecology should be emphasized.

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Incidence of Surgical Site Infection and Risk Factors in Rectal Surgery: A Prospective Cohort Study

Cited by 10 publications

References 26 publications

Risk factors for surgical site infection in patients undergoing colorectal surgery: A meta-analysis of observational studies

Risk factors for surgical site infection in patients undergoing colorectal surgery: A meta-analysis of observational studies

Evaluation of compliance with the antibiotic prophylaxis protocol in breast surgery and its effect on the incidence of surgical infection

Evaluation of compliance with the antibiotic prophylaxis protocol in hysterectomy. Prospective cohort study

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