Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery.
OBJECTIVE
To assess the risk factors of surgical site infection (SSI) in gastrointestinal surgery.


METHODS
Surgical site infection surveillance was conducted in 27 hospitals.


RESULTS
The incidence of SSI in the 941 patients studied was 15.5%. The factors associated with SSI were body mass index (BMI), comorbidity, emergency procedures, wound classification, blood loss, the suture material used for intra-abdominal ligation, the method of subcutaneous incision, the frequency of glove changes, and the absence of subcutaneous sutures. In lower alimentary tract procedures, additional factors influencing the incidence of SSI were sex, smoking status, operating time, the suture material used for abdominal wound closure and seromuscular sutures, and the combined resection procedures. According to a multiple logistic regression analysis, the independent risk factors for SSI were as follows: the type of operation, blood loss, wound classification, emergency procedures, the frequency of glove changes, the use of subcutaneous sutures, combined resection procedures, and the material used for seromuscular suturing.


CONCLUSIONS
Strict asepsis and minimal blood loss were associated with a lower incidence of SSI following gastrointestinal surgery. The use of absorbable suture material may be involved in reducing the risk of SSI.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Akihiro
A
Watanabe
Shunji
S
Kohnoe
Rinshun
R
Shimabukuro
Takeharu
T
Yamanaka
Yasunori
Y
Iso
Hideo
H
Baba
Hidefumi
H
Higashi
Hiroyuki
H
Orita
Yasunori
Y
Emi
Ikuo
I
Takahashi
Daisuke
D
Korenaga
Yoshihiko
Y
Maehara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001207:Asepsis / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002648:Child; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013537:Sutures