Risk factors for surgical-wound infection in general surgery: a prospective study.
OBJECTIVE
To quantify surgical-infection rate, to assess adherence with the antibiotic prophylaxis protocol, and to identify independent factors associated with surgical-wound infection (SWI).


METHODS
We carried out a prospective study of a cohort of 2,237 general surgery patients with postsurgery stays of more than 48 hours. Odds ratios (OR) were estimated using unconditional multiple logistic regression.


METHODS
A 1,300-bed, university-affiliated, tertiary-care hospital in Madrid, Spain.


RESULTS
254 patients developed SWI. The rate of adherence to the antibiotic prophylaxis protocol was 63.5%. Eight factors were independently associated with risk of SWI: age (OR = 1.2 for every 10 years of age); wound classification (clean-contaminated, OR = 6.4; contaminated, OR = 3.7; dirty or infected, OR = 9.3); antimicrobial prophylaxis (OR = 0.5); stay prior to surgery (OR = 1.1 for every 3 days); duration of operation (OR = 1.5 for every 60 minutes); malignant neoplasm (OR = 1.7); emergency procedure (OR = 1.99); intensive-care unit stay prior to surgery (OR = 2.6); and antimicrobial prophylaxis administered 2 or more hours before operation (OR = 5.3).


CONCLUSIONS
In general, antimicrobial prophylaxis protects against SWI (OR = 0.5); however, administration 2 hours or more before the operation increases the risk of SWI by a factor of 5.3. Therefore, measures should be taken to ensure the correct timing of antimicrobial prophylaxis.
Lizán-García
M
M
Unidad de Medicina Preventiva, Hospital General de Albacete, Spain.
García-Caballero
J
J
Asensio-Vegas
A
A
D019072:Antibiotic Prophylaxis / Q000592:standards / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors