Incidence and risk factors for surgical site infection after gastric surgery: a multicenter prospective cohort study.
BACKGROUND
Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. While gastrointestinal surgery is relatively common in Korea, few studies have evaluated SSI in the context of gastric surgery. Thus, we performed a prospective cohort study to determine the incidence and risk factors of SSI in Korean patients undergoing gastric surgery.


METHODS
A prospective cohort study of 2,091 patients who underwent gastric surgery was performed in 10 hospitals with more than 500 beds (nine tertiary hospitals and one secondary hospital). Patients were recruited from an SSI surveillance program between June 1, 2010, and August 31, 2011 and followed up for 1 month after the operation. The criteria used to define SSI and a patient's risk index category were established according to the Centers for Disease Control and Prevention and the National Nosocomial Infection Surveillance System. We collected demographic data and potential perioperative risk factors including type and duration of the operation and physical status score in patients who developed SSIs based on a previous study protocol.


RESULTS
A total of 71 SSIs (3.3%) were identified, with hospital rates varying from 0.0 - 15.7%. The results of multivariate analyses indicated that prolonged operation time (P = 0.002), use of a razor for preoperative hair removal (P = 0.010), and absence of laminar flow in the operating room (P = 0.024) were independent risk factors for SSI after gastric surgery.


CONCLUSIONS
Longer operation times, razor use, and absence of laminar flow in operating rooms were independently associated with significant increased SSI risk after gastric surgery.
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Su Jin
SJ
Jeong
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hea Won
HW
Ann
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jae Kyung
JK
Kim
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Heun
H
Choi
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Chang Oh
CO
Kim
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sang Hoon
SH
Han
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jun Yong
JY
Choi
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kyong Ran
KR
Peck
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cheol-In
CI
Kang
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Joon-Sup
JS
Yeom
Department of Pulmonary and Critical Care Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Young Hwa
YH
Choi
Department of Pulmonary and Critical Care Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Seung-Kwan
SK
Lim
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Young Goo
YG
Song
Department of Internal Medicine, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Hee Jung
HJ
Choi
Division of Infectious Diseases, Department of Intermal Medicine, Eulji University College of Medicine, Daejeon, Korea.
Hee Jung
HJ
Yoon
Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Hyo-Youl
HY
Kim
Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Young-Keun
YK
Kim
Division of Infectious Diseases, Department of Internal Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Min Ja
MJ
Kim
Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
Yoon Seon
YS
Park
Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
June Myung
JM
Kim
Gastric surgery; Risk factors; Surgical site infection