Olguín Joseau Santiago, Bollati Natalia Paola, Reimondez Santiago, Signorini Franco, Rossini Alejandro Mario, Maldonado Pablo Sergio, Moser Federico, Obeide Lucio Ricardo, Alcaraz Alvaro, Caeiro Juan Pablo
Hospital Privado Universitario de Córdoba.
Rev Fac Cien Med Univ Nac Cordoba. 2018 Nov 14;75(4):229-233. doi: 10.31053/1853.0605.v75.n4.19647.
Surgical site infection (SSI) is the most common nosocomial infection in surgical patients with an incidence that varies between 5-30%.
Identify the risk factors for SSI in colonic surgery in our population. The secondary aims are to determine the incidence and type of SSI, as well as the incidence of an anastomotic leakage (AL).
Case-control study of patients undergoing colectomy between 2010-2014 at the Hospital Privado Univeristario de Córdoba and Hospital Raúl Ferreyra. Conventional and laparoscopic interventions, with a 30-day postoperative follow up, between 20-85 years and an ASA I-III were included. Patients undergoing emergency surgery and recto-anal resections were excluded. SSI was defined as an infection that occurred within 30 days after surgery.
We included 238 patients. SSI was diagnosed in 27.7% (n=66) of the patients of which 12.2% were superficial, 4.6% deep incisional and 10.9% organ/space. Multivariate analysis showed that SSI was independently associated with male sex (odds ratio [OR] 3.15; IC95%:1.43-6.92; p=0.004), having undergone previous chemotherapy (OR 6.72; IC95%:1.48-30.93; p=0.01), need for conversion (OR 3.32; IC95%:1.13-9.77; p=0.02), reintervention within the 30 postoperative days (OR 12.34; IC95%:2.65-57.37, p=0.001) and AL (OR 12.83; IC95%:2.97- 55.5; p=0.001). AL had an incidence of 9.6%, of which 91% presented SSI and all were organ/space.
We found that male sex, having undergone previous chemotherapy, conversion, reintervention within 30 postoperative days and AL are risk factors for SSI in our population. These results should be considered in implementing preventive measures for SSI.
手术部位感染（SSI）是外科手术患者中最常见的医院感染，发生率在5%-30%之间。
确定我们人群中结肠手术SSI的危险因素。次要目的是确定SSI的发生率和类型，以及吻合口漏（AL）的发生率。
对2010年至2014年在科尔多瓦私立大学医院和劳尔·费雷拉医院接受结肠切除术的患者进行病例对照研究。纳入20-85岁、ASA I-III级的常规和腹腔镜手术患者，术后随访30天。排除急诊手术和直肠肛管切除术患者。SSI定义为术后30天内发生的感染。
我们纳入了238例患者。27.7%（n=66）的患者被诊断为SSI，其中12.2%为浅表感染，4.6%为深部切口感染，10.9%为器官/腔隙感染。多因素分析显示，SSI与男性（比值比[OR]3.15；95%置信区间：1.43-6.92；p=0.004）、既往接受过化疗（OR 6.72；95%置信区间：1.48-30.93；p=0.01）、需要中转手术（OR 3.32；95%置信区间：1.13-9.77；p=0.02）、术后30天内再次干预（OR 12.34；95%置信区间：2.65-57.37，p=0.001）和AL（OR 12.83；95%置信区间：2.97-55.5；p=0.001）独立相关。AL的发生率为9.6%，其中91%发生了SSI，且均为器官/腔隙感染。
我们发现男性、既往接受过化疗、中转手术、术后30天内再次干预和AL是我们人群中SSI的危险因素。在实施SSI预防措施时应考虑这些结果。
