Surgical site infection in elective operations for colorectal cancer after the application of preventive measures.

OBJECTIVES

To assess the prevalence of surgical site infection (SSI) after elective operations for colon and rectal cancer after the application of evidence-based preventive measures and to identify risk factors for SSI.

DESIGN

Prospective, observational, multicenter.

SETTING

Tertiary and community public hospitals in Catalonia, Spain.

PATIENTS

Consecutive patients undergoing elective surgical resections for colon and rectal cancer during a 9-month period.

MAIN OUTCOME MEASURES

The prevalence of SSI within 30 days after the operations and risk factors for SSI.

RESULTS

Data from 611 patients were documented: 383 patients underwent operations for colon cancer and 228 underwent operations for rectal cancer. Surgical site infection was observed in 89 (23.2%) colon cancer patients (superficial, 12.8%; deep, 2.1%; and organ/space, 8.4%) and in 63 (27.6%) rectal cancer patients (superficial, 13.6%; deep, 5.7%; and organ/space, 8.3%). For colon procedures, the following independent predictive factors were identified: for incisional SSI, open procedure vs laparoscopy; for organ/space SSI, hyperglycemia at 48 hours postoperatively (serum glucose level, >200 mg/dL), ostomy, and National Nosocomial Infection System index of 1 or more. In rectal procedures, no risk factors were identified for incisional SSI; hyperglycemia at 48 hours postoperatively (serum glucose level, >200 mg/dL) and temperature lower than 36°C at the time of surgical incision were associated with organ/space SSI.

CONCLUSION

The prevalence of SSI in elective colon and rectal operations remains high despite the application of evidence-based preventive measures.