title: Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program.
abstract: OBJECTIVE
  The purpose of this study was to characterize the rates of surgical site infections (SSI) associated with colorectal procedures in children and the relative burden of these events within the scope of pediatric surgical practice.
  
  
  METHODS
  The NSQIP-Pediatric Public Use File was queried for all pediatric surgery procedures captured from 50 hospitals during 2012-2013. Rates of incisional and deep organ/space SSIs (ISSI and OSI, respectively) were calculated for all procedures, and the relative burden of SSIs from the entire dataset attributable to colorectal procedures was determined.
  
  
  RESULTS
  Colorectal procedures accounted for 2.5% (2872/114,395) of the NSQIP-P caseload and contributed 7.1% of the SSI burden. The SSI rate for all colorectal procedures was 5.9% (ISSI:3.2%; OSI:2.7%), and the highest rates were associated with total abdominal colectomy (11.4%) partial colectomy (8.3%), and colostomy closure (5.0%). Inflammatory bowel disease contributed the greatest relative burden of SSIs among colorectal diagnoses (24.9%; ISSI:22%; OSI:28.6%), followed by Hirschsprung's Disease (14.2%; ISSI:15.4%; OSI:12.8%) and anorectal malformations (12.4%; ISSI:17.6%; OSI:6.4%).
  
  
  CONCLUSIONS
  Colorectal procedures are responsible for a disproportionate burden of SSIs within pediatric surgery. The rate and relative burden of SSIs are particularly high for colostomy closure, partial colectomy, and procedures for inflammatory bowel disease. Efforts to reduce SSI burden may be best focused on this cohort of children.
authors.affiliation: Boston Children's Hospital, Department of Surgery.
authors.forename: Christina
authors.initials: C
authors.lastname: Feng
authors.affiliation: Boston Children's Hospital, Department of Surgery.
authors.forename: Feroze
authors.initials: F
authors.lastname: Sidhwa
authors.affiliation: Boston Children's Hospital, Department of Surgery.
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Cameron
authors.affiliation: Boston Children's Hospital, Department of Surgery.
authors.forename: Charity
authors.initials: C
authors.lastname: Glass
authors.affiliation: Boston Children's Hospital, Department of Surgery. Electronic address: Shawn.Rangel@childrens.harvard.edu.
authors.forename: Shawn J
authors.initials: SJ
authors.lastname: Rangel
mesh_terms: D000293:Adolescent; D001006:Anus, Imperforate / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000009:adverse effects*; D003125:Colostomy / Q000009:adverse effects*; D020345:Enterocolitis, Necrotizing / Q000601:surgery; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D008297:Male; D058996:Quality Improvement; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology
keywords: Infection burden; NSQIP-P; Pediatric colorectal surgery; Surgical site infection