Systematic review and meta-analysis of the risk factors of surgical site infection in patients with colorectal cancer

Abstract

Background Surgical site infection (SSI) influenced the result of surgical treatment, which was known as the second most prevalent hospital-based infection. But, the factors of SSI are not uniform. The purpose of this study was to identify the risk factors of SSI in patients with colorectal cancer. We conducted a meta-analysis of epidemiological research to provide a scientific basis for the prevention of SSI. Methods The PubMed, Medline, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases were independently searched by 2 researchers to identify all relevant studies. Studies were selected if they met the selection criteria, which was defined according to the PICOS principles. The quality of the evidence was assessed using Egger’s P value, study heterogeneity, and sample size. Studies were categorized into 3 groups as follows: low quality (Class 4), moderate quality (Class 2/3), and high quality (Class 1). The meta-analysis was performed using RevMan 5.3 software. Results A total of 17 studies involving 61,611 patients were included in the meta-analysis. The results identified 7 patient-related risk factors of SSI, including male gender, obesity, diabetes mellitus, American Society of Anesthesiologists (ASA) score, cigarette smoking, tumor location, and serum albumin level, and 5 treatment-related risk factors, including laparoscopic surgery, operation time, blood loss, blood transfusion, and abdominal surgical history. Age was not directly related to SSI in colorectal cancer. Conclusions It is possible that patients can be treated effectively by identifying these factors of SSI.

A meta‐analysis examined the effect of stoma on surgical site wound infection in colorectal cancer

“…However, additional studies are still required to demonstrate these prospective associations and to associate the impact of a stoma with the consequences studied. This was suggested also in previous similar meta‐analyses study which showed similar promising outcomes 25 , 26 , 27 , 28 Well‐conducted randomised controlled trials are needed to assess these factors and the combination of different ages, gender, ethnicity, and other variants of subjects; since our meta‐analysis study could not answer whether different gender, ages, and ethnicity are related to the results.…”

Smoking Cessation for Preoperative Optimization

“…54 55 Both superficial and deep/organ space infections are associated with smoking. 38 45 47 56 57 58 Smoking is also associated with increased risk of skin flap necrosis in mastectomy, recurrence after groin hernia repair, wound disruption in plastic surgery and head and neck surgery, and incisional hernia formation. 59 60 61 62 Wound healing in orthopaedic surgery is impaired, with smokers experiencing higher rates of bone nonunion, delayed union, and delayed healing with prosthetic implants.…”

Comorbidities directly extracted from the hospital database for adjusting SSI risk in the new national semiautomated surveillance system in France: The SPICMI network

“…The NNIS risk index components (ASA anesthetic risk score, Altemeier contamination class, duration of the operation, 3 and emergency versus elective) were recovered from the operative room database which is separated from the HDD. 10 These 6 comorbidities were selected according to literature review: arterial hypertension, 14,19 diabetes, [11][12][13][14][15] cancer, 16,17 immunosuppression, 18 malnutrition, 19 and obesity. 12,19 They were directly extracted from the HDD using defined International Classification of Diseases Tenth Revision (ICD-10) codes, as well as age, sex, length of preoperative stay, and outpatient surgery.…”