Risk Factors for Surgical Site Infections After Elective Gastrectomy

被引:35
作者
Migita, Kazuhiro [1 ]
Takayama, Tomoyoshi [1 ]
Matsumoto, Sohei [1 ]
Wakatsuki, Kohei [1 ]
Enomoto, Koji [1 ]
Tanaka, Tetsuya [1 ]
Ito, Masahiro [1 ]
Nakajima, Yoshiyuki [1 ]
机构
[1] Nara Med Univ, Dept Surg, Kashihara, Nara 6348522, Japan
关键词
Surgical site infection; Gastrectomy; Short-term outcome; ULTRASONICALLY ACTIVATED SHEARS; ALLOGENEIC BLOOD-TRANSFUSION; GASTRIC-CANCER SURGERY; WOUND-INFECTION; MORTALITY; MORBIDITY; RESECTION; TRIAL; D2; LYMPHADENECTOMY;
D O I
10.1007/s11605-012-1838-1
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The aim of this study was to identify the risk factors for surgical site infections (SSIs) after elective gastrectomy. This study reviewed the medical records of 842 patients who underwent elective gastrectomy. Multivariate analyses were performed to determine the risk factors for SSIs. Superficial incisional, deep incisional, and organ/space SSIs were detected in 50 (5.9%) patients, 2 (0.2%) patients, and 90 (10.7%) patients, respectively. A multivariate analysis demonstrated that female gender ( = 0.0332) and allogenic blood transfusion ( = 0.0266) were independent predictors for superficial incisional SSIs, while a male gender ( = 0.0355), corticosteroid therapy ( = 0.037), total gastrectomy ( < 0.0001), and a duration of operation a parts per thousand yen300 min ( = 0.0062) were independent predictors for organ/space SSIs. The median length of postoperative hospital stay was significantly longer in patients with organ/space SSIs in comparison to those without SSIs ( < 0.0001) and with superficial incisional SSIs ( < 0.0001). The patients with organ/space SSIs had a significantly higher re-operation rate in comparison to those without SSIs ( < 0.0001). The risk factors both for incisional SSIs and for organ/space SSIs are strongly associated with surgical results. Meticulous surgical techniques are therefore required to prevent SSIs.
引用
收藏
页码:1107 / 1115
页数:9
相关论文
共 28 条
[1]   Intraoperative Transfusion of 1 U to 2 U Packed Red Blood Cells Is Associated with Increased 30-Day Mortality, Surgical-Site Infection, Pneumonia, and Sepsis in General Surgery Patients [J].
Bernard, Andrew C. ;
Davenport, Daniel L. ;
Chang, Phillip K. ;
Vaughan, Taylor B. ;
Zwschenberger, Joseph B. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2009, 208 (05) :931-937
[2]   Morbidity and mortality in the Italian Gastric Cancer Study Group randomized clinical trial of D1 versus D2 resection for gastric cancer [J].
Degiuli, M. ;
Sasako, M. ;
Ponti, A. .
BRITISH JOURNAL OF SURGERY, 2010, 97 (05) :643-649
[3]   Thickness of Subcutaneous Fat as a Strong Risk Factor for Wound Infections in Elective Colorectal Surgery: Impact of Prediction Using Preoperative CT [J].
Fujii, Takaaki ;
Tsutsumi, Soichi ;
Matsumoto, Asuka ;
Fukasawa, Takaharu ;
Tabe, Yuichi ;
Yajima, Reina ;
Asao, Takayuki ;
Kuwano, Hiroyuki .
DIGESTIVE SURGERY, 2010, 27 (04) :331-335
[4]   Impact of Blood Transfusion on Early Outcome of Liver Resection for Colorectal Hepatic Metastases [J].
Gruttadauria, Salvatore ;
Chaumet, Maureen Saint Georges ;
Pagano, Duilio ;
Marsh, J. Wallis ;
Bartoccelli, Carlo ;
Cintorino, Davide ;
Arcadipane, Antonio ;
Vizzini, Giovanni ;
Spada, Marco ;
Gridelli, Bruno .
JOURNAL OF SURGICAL ONCOLOGY, 2011, 103 (02) :140-147
[5]   Efficacy of protocol implementation on incidence of wound infection in colorectal operations [J].
Hedrick, Traci L. ;
Heckman, James A. ;
Smith, Robert L. ;
Sawyer, Robert G. ;
Friel, Charles M. ;
Foley, Eugene F. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2007, 205 (03) :432-438
[6]   BENEFICIAL EFFECT OF AUTOLOGOUS BLOOD-TRANSFUSION ON INFECTIOUS COMPLICATIONS AFTER COLORECTAL-CANCER SURGERY [J].
HEISS, MM ;
MEMPEL, W ;
JAUCH, KW ;
DELANOFF, C ;
MAYER, G ;
MEMPEL, M ;
EISSNER, HJ ;
SCHILDBERG, FW .
LANCET, 1993, 342 (8883) :1328-1333
[7]   Allogeneic blood transfusion increases the risk of postoperative bacterial infection: A meta-analysis [J].
Hill, GE ;
Frawley, WH ;
Griffith, KE ;
Forestner, JE ;
Minei, JP .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2003, 54 (05) :908-914
[8]   Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery [J].
Imai, Eiko ;
Ueda, Masakazu ;
Kanao, Kent ;
Kubota, Tetsuro ;
Hasegawa, Hirotoshi ;
Omae, Kazuyuki ;
Kitajima, Masaki .
AMERICAN JOURNAL OF INFECTION CONTROL, 2008, 36 (10) :727-731
[9]  
Imai Eiko, 2005, Journal of Infection and Chemotherapy, V11, P141, DOI 10.1007/s10156-005-0379-x
[10]  
Japanese Gastric Cancer Association, 1998, Gastric Cancer, V1, P10