Wound complications after gynecologic cancer surgery

Nugent, E.; Hoff, John S.; Gao, Feng; Massad, L. Stewart; Case, Ashley S.; Zighelboim, Israel; Mutch, David G.; Thaker, Premal H.

doi:10.1016/j.ygyno.2011.01.026

Cited by 61 publications

(48 citation statements)

References 22 publications

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“…Contrary to the finding presented by Brummer et al 3 we found that previous laparotomy was strongly associated with an increased risk of complications. Our finding is consistent with that of Nugent et al 20 who found that prior laparotomy was a very There are certain methodological limitations of the study. The "GASPI" study was designed and powered to compare differences in length of hospital stay 17 .…”

Section: Discussionsupporting

confidence: 92%

Risk factors for postoperative complications after fast‐track abdominal hysterectomy

Nilsson¹,

Wodlin²,

Kjølhede³

2012

Aust NZ J Obst Gynaeco

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Section: Discussionsupporting

confidence: 92%

Risk factors for postoperative complications after fast‐track abdominal hysterectomy

Nilsson¹,

Wodlin²,

Kjølhede³

2012

Aust NZ J Obst Gynaeco

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“…Significant independent risk factors have been previously identified, both in plastic surgery and in other specialities (40,44,45,50,72,(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93). However, the advantage of the present study is the evaluation of four different reconstruction methods with the same criteria for complications.…”

Section: Discussionmentioning

confidence: 92%

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

et al. 2017

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being, health-related quality of life and satisfaction (5,7-10).Patients' satisfaction and health-related quality of life are frequently used as parameters for outcome measurement in plastic surgery. Postoperative complications after breast reconstruction are common and affect patient satisfaction.Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. 2.05, 95% confidence interval (CI) 1.25-3.37, P=0.0005], followed by body mass index (BMI) (OR 1.07, 95% CI 1.01-1.13, P=0.017). High BMI was associated with the highest number of late overall postoperative complications (OR 1.06, 95% CI 1.00-1.11, P=0.042), followed by history of radiotherapy (OR 1.66, 95% CI 1.01-2.74, P=0.046). When the risk factors were combined, the risk for postoperative complications rose exponentially.Conclusions: Our results provide evidence that patients should cease smoking and overweight patients should lose weight before undergoing breast reconstruction. Additionally, if the patient has received radiotherapy, the reconstruction method should be carefully chosen. High BMI, history of radiotherapy, and smoking are independent risk factors for many types of both early and late postoperative complications in breast reconstructive surgery. Combining these risk factors multiplies the risk of postoperative complications.

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“…It is the third most common (17%) [1] of all nosocomial infections in hospitalized patients, and is a significant cause of postoperative morbidity, mortality, and healthcare costs [2–4]. …”

Section: Introductionmentioning

confidence: 99%

Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients

Al-Niaimi¹,

Ahmed²,

Burish³

et al. 2015

Gynecologic Oncology

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Objective SSI rates after gynecologic oncology surgery vary from 5% to 35%, but are up to 45% in patients with diabetes mellitus (DM). Strict postoperative glucose control by insulin infusion has been shown to lower morbidity, but not specifically SSI rates. Our project studied continuous postoperative insulin infusion for 24 h for gynecologic oncology patients with DM and hyperglycemia with a target blood glucose of <139 mL/dL and a primary outcome of the protocol's impact on SSI rates. Methods We compared SSI rates retrospectively among three groups. Group 1 was composed of patients with DM whose blood glucose was controlled with intermittent subcutaneous insulin injections. Group 2 was composed of patients with DM and postoperative hyperglycemia whose blood glucose was controlled by insulin infusion. Group 3 was composed of patients with neither DM nor hyperglycemia. We controlled for all relevant factors associated with SSI. Results We studied a total of 372 patients. Patients in Group 2 had an SSI rate of 26/135 (19%), similar to patients in Group 3 whose rate was 19/89 (21%). Both were significantly lower than the SSI rate (43/148, 29%) of patients in Group 1. This reduction of 35% is significant (p = 0.02). Multivariate analysis showed an odd ratio = 0.5 (0.28–0.91) in reducing SSI rates after instituting this protocol. Conclusions Initiating intensive glycemic control for 24 h after gynecologic oncology surgery in patients with DM and postoperative hyperglycemia lowers the SSI rate by 35% (OR = 0.5) compared to patients receiving intermittent sliding scale insulin and to a rate equivalent to non-diabetics.

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Wound complications after gynecologic cancer surgery

Cited by 61 publications

References 22 publications

Risk factors for postoperative complications after fast‐track abdominal hysterectomy

Risk factors for postoperative complications after fast‐track abdominal hysterectomy

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients

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