title: Factors predicting incisional surgical site infection in patients undergoing open radical cystectomy for bladder cancer.
abstract: BACKGROUND
  The risk factors of incisional surgical site infection (iSSI) after open radical cystectomy (ORC) have not been fully investigated. The aim of the present study is to examine factors correlated with iSSI development after ORC with intestinal urinary diversion.
  
  
  METHODS
  A total of 178 patients who had undergone ORC with intestinal urinary diversion between 2003 and 2012 at our institution were included in this retrospective study. Correlations between different perioperative factors and iSSI development were determined using univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  iSSI was observed in 53 patients (29.8 %). In the univariate analysis, age, diabetes mellitus, thickness of subcutaneous fat (TSF), and allogeneic transfusion were significant predictors of iSSI development. Although subcutaneous closed-suction drainage (SCSD) was not a significant factor in univariate analysis, SCSD, age, and TSF were all finally identified as independent predictors of iSSI development (P = 0.020, P < 0.001, and P = 0.022, respectively). Further analyses demonstrated that SCSD was frequently used in patients with relatively thick subcutaneous fat tissue and that SCSD significantly decreased iSSI development in these patients.
  
  
  CONCLUSIONS
  Advanced patient age, thick subcutaneous fat tissue, and the absence of SCSD were significantly associated with iSSI development in bladder cancer patients who underwent ORC with intestinal urinary diversion. SCSD may be a useful procedure for iSSI prevention, especially in patients with relatively thick subcutaneous fat tissue.
authors: Department of Urology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors: Tatsuo
authors: T
authors: Gondo
authors: Yoshio
authors: Y
authors: Ohno
authors: Jun
authors: J
authors: Nakashima
authors: Takeshi
authors: T
authors: Hashimoto
authors: Issei
authors: I
authors: Takizawa
authors: Ayako
authors: A
authors: Tanaka
authors: Kenji
authors: K
authors: Shimodaira
authors: Naoya
authors: N
authors: Satake
authors: Hisashi
authors: H
authors: Takeuchi
authors: Yoshihiro
authors: Y
authors: Nakagami
authors: Makoto
authors: M
authors: Ohori
authors: Masaaki
authors: M
authors: Tachibana
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007239:Infections / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013396:Suction; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery