Risk factors for tissue and wound complications in gastrointestinal surgery.
BACKGROUND
Surgical site infections and disruption of sutured tissue are frequent complications following surgery. We aimed to assess risk factors predictive of tissue and wound complications in open gastrointestinal surgery.


METHODS
Data from 4855 unselected patients undergoing open gastrointestinal surgery from 1995 through 1998 were recorded in a clinical database and validated. The database embraced variables related to patient history, preoperative clinical condition, operative findings and severity, and the surgeon's training. Variables predictive of surgical site infection and dehiscence of sutured tissue within 30 days after surgery were assessed by multiple logistic regression analysis.


RESULTS
Following elective operation, the incidence of tissue and wound complications was 6% compared with 16% in emergency surgery (P < 0.001). These complications resulted in prolonged hospitalization in 50% of the patients and a 3-fold higher risk of reoperation but not increased mortality. Factors associated with complications following elective operations were smoking, comorbidity, and perioperative blood loss. Following emergency operations, male gender, peritonitis, and multiple operations were predictors of complications. Irrespective of elective or emergency surgery, the type of operation was a predictor of complications.


CONCLUSIONS
Factors known to affect the process of tissue and wound healing are independently associated with tissue and wound complications following gastrointestinal surgery.
Sørensen
Lars Tue
LT
Department of Surgical Gastroenterology, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark. Its@dadlnet.dk
Hemmingsen
Ulla
U
Kallehave
Finn
F
Wille-Jørgensen
Peer
P
Kjaergaard
Johan
J
Møller
Lisbeth Nørgaard
LN
Jørgensen
Torben
T
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