Surgical site Infection after gastrointestinal and hepatobiliary surgeries- A retrospective evaluation from a single center of western India.

Abstract

Introduction: Aim of our study to evaluate various factors responsible for surgical site infection after gastrointestinal and hepatobiliary surgeries.Methods: Patients who underwent gastrointestinal and hepatobiliary surgery in our department were evaluated retrospectively. Various factors associated with surgical site infection were evaluated using univariate and multivariate analysis. Surgical site infection was defined as any culture positive discharge from the wound within 30 days of surgery.Results: We evaluated a total of 331 patients operated between April 2018 and March 2020. 14 patients were lost to follow up after discharge and before completing post operative day 30. Eighteen patients expired before 30 days without developing SSI and were excluded from the study as per exclusion criteria. 299 patients were included in the study. Twenty patients developed surgical site infection. It showed SSI rate in our study population was 6.68%. On univariate analysis prolonged hospital stay, more blood product used, higher CDC grade of surgery, higher ASA grade, more operative time, open surgeries, colorectal and HPB surgeries were associated with surgical site infections. On multivariate analysis only prolonged hospital stay independently predicted SSI. (p=0.014, Odds ratio 1.223, 95% confidence interval 1.042-1.435.).Conclusion: Prolonged hospital stay independently predicts surgical site infections after gastrointestinal and hepatobiliary surgery.
 
 

Author Biography

Bhavin Vasavada, shalby hospitals
CONSULTANT HEPATOBILIARY AND LIVER TRANSPLANT, SHALBY HOSPITALS, AHMEDABAD

References

1. Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence based global perspective. Lancet Infect Dis. 2016;16(12):e276-e287.
2. GlobalSurg Collaborative. Surgical site infection after gastrointestinal surgery in high-income, middleincome,
and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis. 2018;18(5):516-25.
3. Ohno M, Shimada Y, Satoh M, Kojima Y, Sakamoto K, Hori S. Evaluation of economic burden of colonic surgical site infection at a Japanese hospital. J Hosp Infect. 2018;99(1):31-35.
4. Akhter MS, Verma R, Madhukar KP, Vaishampayan AR, Unadkat PC. Incidence of surgical site infection in postoperative patients at a tertiary care centre in India. J Wound Care. 2016;25(4):210–2, 214-7.
5. Singh S, Chakravarthy M, Rosenthal VD, Myatra SN, Dwivedy A, Bagasrawala I et al. Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC). Int Health. 2015 Sep;7(5):354–9.
6. Wang Z, Chen J, Wang P, Jie Z, Jin W, Wang G et al. Surgical Site Infection After Gastrointestinal Surgery in China: A Multicenter Prospective Study. J Surg Res. 2019 Aug;240:206–218.
7. Castro PTO, Carvalho AL, Peres SV, Foschini MM, Passos ADC. Surgical-site infection risk in oncologic digestive surgery. Braz J Infect Dis. Mar-Apr 2011;15(2):109-15.
8. Shatney CH, Antibiotic prophylaxis in elective gastro-intestinal tract surgery: a comparison of single dose pre-operative cefotaxime and multiple-dose cefoxitin. Journal of Antimicrobial Chemotherapy. 1984;14(suppl_B):241–5.
9. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304–377.
10. Onyekwelu I, Yakkanti R, Protzer L, Pinkston CM, Tucker C, Seligson D. Surgical Wound Classification
and Surgical Site Infections in the Orthopaedic Patient. J Am Acad Orthop Surg Glob Res Rev. 2017
Jun 13;1(3):e022.
11. Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011
Mar;55(2):111–5.
12. Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp
Infect. 2008 Nov;70 Suppl 2:3-10.
13. Young PY, Khadaroo RG.. Surgical site infections. Surg Clin North Am. 2014 Dec;94(6):1245-64.
14. Lee KY, Coleman K, Paech D, Norris S, Tan JT. The epidemiology and cost of surgical site infections in Korea: a systematic review. J Korean Surg Soc. 2011 Nov;81(5):295-307.
15. Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M. et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013 Dec 18;8(12):e83743.
16. Carvalho RLR, Campos CC, Franco LMC, Rocha ADM, Ercole FF. Incidence and risk factors for surgical site infection in general surgeries. Rev Lat Am Enfermagem. 2017 Dec 4;25:e2848.
17. Varela JE, Wilson SE, NguyenNT. Laparoscopic surgery significantly reduces surgical-site infections
compared with open surgery. Surg Endosc. 2010 Feb;24(2):270-6.
18. Mujagic E, Marti WR, Coslovsky M, Soysal SD, Mechera R, Strauss MV et al. Associations of
Hospital Length of Stay with Surgical Site Infections. World J Surg. 2018 Dec;42(12):3888?96.
19. Astagneau P, Rioux C, Golliot F, Brücker G; INCISO Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997-1999 INCISO surveillance. J Hosp Infect. 2001 Aug;48(4):267-74.
Published
2021-03-10
How to Cite
VASAVADA, Bhavin; PATEL, Hardik. Surgical site Infection after gastrointestinal and hepatobiliary surgeries- A retrospective evaluation from a single center of western India.. J Soc Surg Nep, [S.l.], v. 23, n. 2, p. 31-35, mar. 2021. ISSN 2392-4772. Available at: <http://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=420>. Date accessed: 13 apr. 2021.