Related Factors And Precaution Of Incision Infections In Gastroenteric Operation

BackgroundIncision infection is the most common complication after operation.Compared with clean surgery,gastrointestinal surgery has a higher rate of incision infections,and even parts of contaminated surgery are higher.Both of given perioperative antibiotic prophylaxis and strict aseptic operation couldn’t completely avoid postoperative incision infection.Many factors are found to influence the postoperative incision infection.Analyzing the related factors and adopting some specific intervening measures could control effectively the happening of postoperative incision infection,further ensure the postoperative recovery of surgical patients.PurposeThis research aims to analyze the related factors of incision infection in gastroenteric operation and take reasonable measures in case of the occurrence of it.MethodFrom July 2015 to December 2017,a total of 1,519 patients admitted to the general surgery department of the First Affiliated Hospital of Xinxiang Medical University for gastrointestinal surgery were selected as subjects.By consulting medical history,course of disease records,laboratory lists,special examinations and bacteriological examination reports and other informations,incisional infection was diagnosed according to nosocomial infection criteria(trial).The following factors were selected for analysis: age,gender,diabetes or hypertension,hemoglobin(Hb),albumin(Alb),smoking,operation site,operation method,operation opportunity,type of incision,operation time,intraoperative blood loss.Univariate logistic regression and multivariate logistic regression were used to analyze the related factors of incision infection after gastroenteric operation.Result1.A total of 63 among 1519 patients had incision infections and the infection rate was 4.15%.Among them,29 cases had superficial incision infection,12 cases had deep incision infection,12 cases had organ(lacunar)infection.2.Among the 63 cases of incision infection,pathogens bacteria were detected in 52 cases.The inspection rate was 82.54%,49 cases test positive for pathogens bacteria,the positive rate was 94.23%,3 of the 60 strains were multidrug-resistant.3.The incisional infection rate in male patients was 4.63% and higher than that in female patients(3.29%);The incisional infection rate of patients with Hb<90g/L was 15.53%,higher than that of patients with Hb≥90g/L(2.23%);The incisional infection rate of patients with Alb<30g/L was 8.20%,higher than that of patients with Alb≥30g/L(1.69%);Incisional infection rate was 6.16% with diabetes mellitus,higher than 3.93% without diabetes mellitus;Incisional infection rate with hypertension was 4.09%,lower than that without hypertension;The incisional infection rate of smoking patients was 2.92%,lower than that of non-smoking patients(4.50%);Incisional infection rate in gastric surgery was 3.18%,lower than that in intestinal surgery(4.72%);The incisional infection rate of laparotomy was 5.77%,higher than that of laparoscopic surgery(1.42%);The incisional infection rate of emergency surgery was 5.96%,higher than that of elective surgery(3.53%);Ⅱclass incision infection rate was 1.87%,less than 8.77% of the Ⅲ/Ⅳ class;The average age of incisional infection was 57.90±14.29 years,average operation time was 238.48±110.05 min,average intraoperative blood loss was 473.02±719.23 ml;The average age without incisional infection was 59.02±14.92 years,average operation time was 219.56±99.28 min,average intraoperative blood loss was 237.98±282.53 ml.4.Univariate analysis and multivariate logistic regression analysis showed that operation opportunity,type of incision,operation method,intraoperative blood loss,Hb and Alb were related factors influencing incision infection in patients undergoing gastrointestinal surgery.Conclusion(1)Incision infection in gastrointestinal operation is associated with the risk factors of patients themselves: perioperative Hb<90g/L,Alb<30g/L.(2)The influencing factors of incision infection in gastrointestinal surgery includes incision type,operation opportunity and intraoperative blood loss.(3)Laparoscopy is a protective factor for incision infection after gastrointestinal surgery,in other words,laparoscopic surgery can reduce the incidence of incision infection after gastrointestinal operation.