Surgical wound infections after vascular surgery: prospective multicenter observational study.
OBJECTIVE
this multicenter prospective observational study defined the incidence and risk factors of surgical wound infections (SWI) after infrarenal aortic and lower limb vascular surgery procedures and evaluated the severity and costs of these infections.


METHODS
the study cohort comprised of 184 consecutive patients. Postoperative complications were recorded. The additional costs attributable to SWI were calculated.


RESULTS
Eighty-four (46%) patients had critical ischaemia, 81 (45%) patients underwent infrainguinal bypass surgery and 64 (35%) received vascular prosthesis or prosthetic patch. Forty-nine (27%) patients developed SWI. Staphylococcus aureus was the leading pathogen cultured from the wound. Forty-seven of the 49 infected wounds responded to and healed with the treatment. SWI was the cause of one major amputation. Independent predictors for SWI were infrainguinal surgery (OR 7.2, 95% Cl 2.92-17.65, p < 0.001), obesity (OR 6.1, 95% Cl 2.44-15.16, p < 0.001) and arteriography injection site within the operative area (OR 2.5, 95% Cl 1.13-5.48, p = 0.02). The average cost attributable to SWI was 3320 Ä.


CONCLUSIONS
the incidence of SWI after vascular surgery is high. The risk factors for SWI are infrainguinal surgery, obesity and arteriography injection site within the operative area. SWI increases morbidity and costs of operative treatment.
Department of Thoracic and Vascular Surgery, North Karelia Central Hospital, Joensuu, Finland. johanna.turtiainen@pkssk.fi
J
J
Turtiainen
E
E
Saimanen
T
T
Partio
J
J
Kärkkäinen
V
V
Kiviniemi
K
K
Mäkinen
T
T
Hakala
D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000191:economics / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D005387:Finland; D006083:Graft Occlusion, Vascular / Q000601:surgery; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000191:economics*