Background
The purpose of this study was to compare risk factors for the development of incisional
versus organ/space infections in patients undergoing colorectal surgery.
Methods
An institutional review board–approved retrospective review was performed examining
a 4-year period (January 2002 to December 2005). Patients were included if they had
undergone abdominal operations (open or laparoscopic) in which the colon/rectum was
surgically manipulated. Patients were excluded if the surgical wound was not closed
primarily. A standardized definition of incisional and organ/space infection was employed.
Results
A total of 428 operations were performed. Overall, 105 infections were identified
(25%); 73 involved the incision and 32 were classified as organ/space. Multivariate
analysis suggested that incisional infection was independently associated with body
mass index (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.11) and creation/revision/reversal
of an ostomy (OR, 2.2; 95% CI, 1.3-3.9). Organ/space infection was independently associated
with perioperative transfusion (OR, 2.3; 95% CI, 1.1-5.5) and with previous abdominal
surgery (OR, 2.5; 95% CI, 1.2-5.3).
Conclusions
Factors associated with infection differed based on the type of surgical site infection
being considered. The lack of overlap between factors associated with incisional infection
and organ/space infection suggests that separate risk models and treatment strategies
should be developed.
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Article info
Publication history
Accepted:
May 12,
2007
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
