title: Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: a multicenter study.
abstract: BACKGROUND
  Surgical site infection (SSI) in patients who underwent colorectal surgery is a common complication associated with increased morbidity and costs. The aim of this study was to assess risk factors for SSI in laparoscopic sigmoid resection for benign disease.
  
  
  METHODS
  Using a multicenter database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery, we prospectively identified 4,488 patients who underwent laparoscopic colorectal surgery between 1995 and 2008; of these, 2,571 patients who underwent sigmoid resection for benign disease were included. Uni- and multivariate analyses were used to determine risk factors for SSI.
  
  
  RESULTS
  The incidence of SSI was 3.5% (90/2,571). Among SSI patients, incisional superficial infections were found in 71%, incisional deep infections in 22%, and organ-space infections in 7%. Patients' age, underlying disease, and surgeons' experience had no impact on SSI. Multivariate analyses showed that operation time >240 min (odds ratio [OR] 1.7; 95% confidence interval [CI] 1.0-2.8), BMI ≥ 27 kg/m(2) (OR 2.3 [1.3-4.5]), organ lesions (OR 7.9 [2.0-31.8]), and male gender (OR 2.3 [1.2-4.5]) were significant risk factors for SSI. Reoperations in the SSI group were significantly more frequent than in the Non-SSI group (30% vs. 3%; p < 0.001). SSI was associated with a significantly longer median hospital stay (15 days, range = 2-69 vs. 8 days, range = 1-69; p < 0.001) and higher mortality rate (2.2% vs. 0.4%; p = 0.019).
  
  
  CONCLUSIONS
  Significant risk factors for SSI were operation time > 240 min, BMI ≥ 27 kg/m(2), organ lesions, and male gender. SSI was significantly associated with more reoperations, longer hospital stay, and higher mortality rate.
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Kurmann
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Vorburger
authors.forename: Daniel
authors.initials: D
authors.lastname: Candinas
authors.forename: Guido
authors.initials: G
authors.lastname: Beldi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D012810:Sigmoid Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology*; D055815:Young Adult