title: Surgical site infections in an Italian surgical ward: a prospective study.
abstract: BACKGROUND
  Surgical site infection (SSI) remains a major cause of morbidity and death. This study analyzed the results of surveillance to evaluate the incidence, risk factors, and characteristics of SSI in patients who underwent an operation in a typical Italian surgical ward.
  
  
  METHODS
  A group of 1,281 patients operated on from August 2005 to December 2007 underwent prospective and direct observation of incisions by a surgeon according to the U.S. Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance (NNIS) method. The minimum follow-up was 30 days. A locally-modified risk index score (LRI) based on the NNIS was calculated for each patient, using as a cut point the 75(th) percentile of the duration of surgery (in minutes) for that particular procedure.
  
  
  RESULTS
  Seventy-six patients were affected by incision site infection, and the SSI rate was 5.9%. Thirty-four (2.6% of the series) were superficial incisional, 32 (2.5%) deep incisional, and 10 (0.8%) organ/space SSIs. An increasing value of the LRI was significantly (p < 0.05) related to an increasing risk of infection. The SSI rates were 0.6%, 3.7%, 7.3%, and 26.8% for LRI value of M = - 1, 0, 1, and >or=2, respectively. Obesity (body mass index >30 kg/m(2)), diabetes mellitus, and emergency surgery were associated with a higher risk of infection by multivariable analysis independent of the LRI.
  
  
  CONCLUSIONS
  The NNIS method can be useful for SSI surveillance and monitoring in single surgical wards. Longer operations, diabetes mellitus, and obesity increase the risk of SSI, as does performance of surgery in an emergency situation.
authors.affiliation: Unit of General Surgery, APSS of Trento, Alto Garda e Ledro Hospital, Arco (TN), Italy. dileomd@libero.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Leo
authors.forename: Silvano
authors.initials: S
authors.lastname: Piffer
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
authors.forename: Alberto
authors.initials: A
authors.lastname: Manzi
authors.forename: Elena
authors.initials: E
authors.lastname: Poggi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Porretto
authors.forename: Paolo
authors.initials: P
authors.lastname: Fambri
authors.forename: Giannina
authors.initials: G
authors.lastname: Piccini
authors.forename: Trentini
authors.initials: T
authors.lastname: Patrizia
authors.forename: Luca
authors.initials: L
authors.lastname: Fabbri
authors.forename: Rosanna
authors.initials: R
authors.lastname: Busetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult