Silvestri Marta, Dobrinja Chiara, Scomersi Serena, Giudici Fabiola, Turoldo Angelo, Princic Elija, Luzzati Roberto, de Manzini Nicolò, Bortul Marina
Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
Division of Infective Diseases, ASUITS and University of Trieste, Trieste, Italy.
Surg Today. 2018 Mar;48(3):338-345. doi: 10.1007/s00595-017-1590-y. Epub 2017 Sep 25.
Surgical site infection (SSI) is the most common complication of colorectal surgery, resulting in significant burden in terms of morbidity and length of hospital stay. The aims of this study were to establish the incidence of SSI in patients undergoing colorectal surgeries and to identify potentially modifiable risk factors to reduce overall SSI rates.
This retrospective study analyzed patients who underwent colorectal resection at our Department. Patients were identified using a prospective SSI database. Univariate and multivariate analyses were used to identify risk factors.
A total of 687 patients were enrolled in the study and the overall SSI rate was 19.9% (137 patients). Superficial incisional surgical site infections (SSSIs) developed in 52 (7.6%) patients, deep incisional surgical site infections (DSSIs) developed in 15 (2.2%), and organ/space infections (OSIs) developed in 70 (10.1%). Univariate and multivariate analyses confirmed that age, diabetes, emergency surgery, and a high infection risk index are risk factors for SSI.
There are some modifiable and non-modifiable risk factors for SSI. IRI and age are non-modifiable, whereas the timing of surgery and diabetes can be modulated by trying to defer some emergency procedures to elective ones and normalizing the glycemia of diabetic patients.
手术部位感染（SSI）是结直肠手术最常见的并发症，在发病率和住院时间方面造成了重大负担。本研究的目的是确定接受结直肠手术患者的SSI发生率，并识别可能可改变的风险因素以降低总体SSI发生率。
这项回顾性研究分析了在我院接受结直肠切除术的患者。通过前瞻性SSI数据库识别患者。采用单因素和多因素分析来识别风险因素。
共有687例患者纳入研究，总体SSI发生率为19.9%（137例患者）。52例（7.6%）患者发生表浅切口手术部位感染（SSSI），15例（2.2%）发生深部切口手术部位感染（DSSI），70例（10.1%）发生器官/腔隙感染（OSI）。单因素和多因素分析证实年龄、糖尿病、急诊手术和高感染风险指数是SSI的风险因素。
SSI存在一些可改变和不可改变的风险因素。IRI和年龄不可改变，而手术时机和糖尿病可以通过尽量将一些急诊手术推迟为择期手术以及使糖尿病患者血糖正常化来调节。
