Surgical-site infection (SSI) is the most prevalent type of hospital infection in surgical patients and is associated with an increase in hospital stay, costs and morbidity/lethality. The knowledge of the main risk factors for this type of infection is important for the establishment of prevention measures regarding modifiable risks factors. The objective of the preset study was to assess the occurrence of SSI and study the risk factors in oncologic surgeries of the digestive system at Hospital de Câncer in Barretos, São Paulo, Brazil. Individuals undergoing oncologic surgeries of the digestive system in the period of 08/01/2007 to 08/10/2008 were prospectively followed for 30 days after surgery. Possible risk factors related to the patient and to the surgical procedure were also studied. A total of 210 surgeries were analyzed, with a global SSI incidence of 23.8%. The following variables were independently associated with SSI: time and type of surgery, radiotherapy before surgery and surgeon's years of experience. The risk factors found in this study have been described by other authors and are not amenable to intervention for SSI prevention. Further studies are recommended with the objective of investigating interventions that could reduce the risk for SSI in this type of surgery.
Journal Information
Vol. 15. Issue 2.
Pages 109-115 (March - April 2011)
Vol. 15. Issue 2.
Pages 109-115 (March - April 2011)
Original article
Open Access
Surgical-site infection risk in oncologic digestive surgery
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Paulo de Tarso Oliveira e Castro1,
, André Lopes Carvalho2, Stela Verzinhasse Peres3, Milene Mitsuyuki Foschini4, Afonso Dinis Costa Passos5
Corresponding author
pitarso@terra.com.br
Correspondence to: Rua Antenor Duarte Villela, N° 1331 14784-400, Barretos, SP, Brazil.
Correspondence to: Rua Antenor Duarte Villela, N° 1331 14784-400, Barretos, SP, Brazil.
1 Infectologist, Hospital de Câncer de Barretos, São Paulo, Brazil
2 Hospital de Câncer de Barretos, São Paulo, Brazil
3 Epidemiologist, Hospital de Câncer de Barretos, São Paulo, Brazil
4 Biostatistician, Hospital de Câncer de Barretos, São Paulo, Brazil
5 Department of Social Medicine of Faculdade de Medicina de Ribeirão Preto, USP, São Paulo, Brazil
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Article information
Abstract
Keywords:
infection
surgical site
oncologic surgery
digestive system surgery
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References
[1.]
A.J. Mangram, T.C. Horan, M.L. Pearson, L.C. Silver, W.R. Jarvis.
Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee.
Infect Control Hosp Epidemiol, 20 (1999), pp. 250-278
[2.]
A.B. Haynes, T.G. Weiser, W.R. Berry, et al.
A surgical safety checklist to reduce morbidity and mortality in a global population.
N Engl J Med., 360 (2009), pp. 491-499
[3.]
D.W. Bratzler, D.R. Hunt.
The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery.
Clin Infect Dis, 43 (2006), pp. 322-330
[4.]
W.J. Martone, R.L. Nichols.
Recognition, prevention, surveillance, and management of surgical site infections: introduction to the problem and symposium overview.
Clin Infect Dis, (2001), pp. S67-S68
[5.]
K.B. Kirkland, J.P. Briggs, S.L. Trivette, W.E. Wilkinson, D.J. Sexton.
The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs.
Infect Control Hosp Epidemiol, 20 (1999), pp. 725-730
[6.]
G. de Lissovoy, K. Fraeman, V. Hutchins, D. Murphy, D. Song, B.B. Vaughn.
Surgical site infection: incidence and impact on hospital utilization and treatment costs.
Am J Infect Control, 37 (2009), pp. 387-397
[7.]
R.P. Gaynes.
Surveillance of surgical-site infections: the world coming together?.
Infect Control Hosp Epidemiol, 21 (2000), pp. 309-310
[8.]
D.E. Fry, R.V. Fry.
Surgical site infection: the host factor.
AORN J, 86 (2007), pp. 801-810
[9.]
A.C. de Oliveira, S.I. Ciosak.
Infecção de sítio cirúrgico em hospital universitário: vigilância pós-alta e fatores de risco.
Rev Esc Enferm USP, 41 (2007), pp. 258-263
[10.]
A. Alves, Y. Panis, G. Mantion, K. Slim, F. Kwiatkowski, E. Vicaut.
The AFC score: validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis: results of a prospective multicenter study in 1049 patients.
Ann Surg., 246 (2007), pp. 91-96
[11.]
F.F. Ercole, C.E. Starling, T.C. Chianca, M. Carneiro.
Applicability of the national nosocomial infections surveillance system risk index for the prediction of surgical site infections: a review.
Braz J Infect Dis, 11 (2007), pp. 134-141
[12.]
T.C. Horan, R.P. Gaynes, W.J. Martone, W.R. Jarvis, T.G. Emori.
CDC definitions of nosocomial surgical site infections, 1992; a modification of CDC definitions of surgical wound infections.
Infect Control Hosp Epidemiol, 13 (1992), pp. 606-608
[13.]
E. Imai, M. Ueda, K. Kanao, K. Miyaki, T. Kubota, M. Kitajima.
Surgical site infection surveillance after open gastrectomy and risk factors for surgical site infection.
J Infect Chemother, 11 (2005), pp. 141-145
[14.]
T. Konishi, T. Watanabe, J. Kishimoto, H. Nagawa.
Elective colon and rectal surgery differ in risk factors for wound infection: results of prospective surveillance.
Ann Surg, 244 (2006), pp. 758-763
[15.]
A.C. de Oliveira, S.I. Ciosak, E.M. Ferraz, R.S. Grinbaum.
Surgical site infection in patients submitted to digestive surgery: risk prediction and the NNIS risk index.
Am J Infect Control, 34 (2006), pp. 201-207
[16.]
R.P. Gaynes, D.H. Culver, T.C. Horan, J.R. Edwards, C. Richards, J.S. Tolson.
Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index.
Clin Infect Dis, (2001), pp. S69-S77
[17.]
D. Vilar-Compte, A. Mohar, S. Sandoval, M. Rosa, P. Gordillo, P. Volkow.
Surgical site infections at the National Cancer Institute in Mexico: A case-control study.
Am J Infect Control, 28 (2000), pp. 14-20
[18.]
E. Velasco, L.C. Santos, C.A. de Souza Martins, L.M. de Castro Dias, V.M. da S.e C. Gonçalves.
Risk index for prediction of surgical site infection after oncology operations.
Am J Infect Control, 26 (1998), pp. 217-223
[19.]
E. Velasco, L.C.S. Thuler, C.A. de Souza Martins, L.M. de Castro Dias, V.M. da S.e C. Gonçalves.
Risk factors for infections complications after abdominal surgery for malignant disease.
Am J Infect Control, 24 (1996), pp. 1-6
[20.]
R.L. Smith, J.K. Bohl, S.T. McElearney, et al.
Wound infection after elective colorectal resection.
Ann Surg, 239 (2004), pp. 599-605
[21.]
C. Platell, J.C. Hall.
The prevention of wound infection in patients undergoing colorectal surgery.
J Hosp Infect, 49 (2001), pp. 233-238
[22.]
M. Delgado-Rodriguez, A. Gomez-Ortega, M. Sillero-Arenas, J. Llorca.
Epidemiology of surgical-site infections diagnosed after hospital discharge: a prospective cohort study.
Infect Control Hosp Epidemiol, 22 (2001), pp. 24-30
[23.]
L. Dominioni, A. Imperatori, N. Rotolo, F. Rovera.
Risk factors for surgical infections.
Surg Infect (Larchmt), (2006), pp. S9-S12
[24.]
E. Imai, M. Ueda, K. Kanao, et al.
Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery.
Am J Infect Control, 36 (2008), pp. 727-731
[25.]
M. Turina, A.M. Mulhall, S.S. Mahid, C. Yashar, S. Galandiuk.
Frequency and surgical management of chronic complications related to pelvic radiation.
Arch Surg, 143 (2008), pp. 46-52
[26.]
R. Wurtz, B. Wittrock, M.A. Lavin, A. Zawacki.
Do new surgeons have higher surgical site infection rates?.
Infect Control Hosp Epidemiol, 22 (2001),
[27.]
J. Muilwijk, S. Hof, J.C. Wille.
Associations Between Surgical Site Infection Risk and Hospital Operation Volume and Surgeon Operation Volume Among Hospitals in the Dutch Nosocomial Infection Surveillance Network.
Infect Control Hosp Epidemiol, 28 (2007), pp. 557-563
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