Does vaginal cuff closure decrease the infectious morbidity associated with abdominal hysterectomy?
BACKGROUND
Infectious morbidity after total abdominal hysterectomy includes fever (31%) and antibiotic administration (45%). Whether vaginal cuff closure reduces postoperative infectious morbidity remains unresolved.


METHODS
We reviewed the records of 172 consecutive abdominal hysterectomies for nonmalignant disease performed at an inner-city hospital. We identified potential risk factors for infectious morbidity by univariate analysis and determined adjusted odds ratios by multiple logistic regression analysis.


RESULTS
The open vaginal cuff technique was associated with an increased risk of wound infection. Use of prophylactic antibiotics was associated with a decreased risk of febrile morbidity and a decreased risk of prolonged hospitalization. Body weight in the heaviest quartile was associated with increased risk of wound infection, increased risk of prolonged hospitalization, and decreased risk of postoperative vaginal cuff granulation tissue. Older age was associated with an increased risk of prolonged hospitalization.


CONCLUSIONS
Closure of the vaginal cuff and use of prophylactic antibiotics at total abdominal hysterectomy were associated with decreased infectious morbidity in a high-risk population.
Korn
A P
AP
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco 94110, USA.
Grullon
K
K
Hessol
N
N
Lin
P
P
Siopak
J
J
D019072:Antibiotic Prophylaxis; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery; D016015:Logistic Models; D009017:Morbidity; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014594:Uterine Neoplasms / Q000601:surgery; D014621:Vagina / Q000601:surgery*