Risk Factors Of Surgical Site Incision Infection In Colorectal Cancer Patients

Objective:There are many bacteria in the intestinal cavity of colorectal cancer,and the flora is complex.Postoperative patients with colorectal cancer are prone to Incisional surgical site infection(I-SSI).I-SSI is the most common complication after colorectal cancer surgery.Once I-SSI occurs,the length of hospital stay will be prolonged,the pain and medical expenses will be increased,and even necrotizing fasciitis will be caused in severe cases,which will pose a threat to life.More importantly,severe I-SSI affects the postoperative quality of life and follow-up treatment.In recent years,with the change of the etiology of infection,the increase of bacterial resistance and the development of various difficult procedures,the treatment of I-SSI is becoming more and more difficult.I-SSI can not be completely eliminated even if antibiotics are used for prevention and strict aseptic operation during perioperative period.The incidence of I-SSI is related to many factors.The analysis of its related factors and targeted intervention measures can effectively reduce the incidence and severity of I-SSI,which is of great significance to reduce the mortality and complication rate after colorectal surgery.This study was to investigate the risk factors and preventive measures of postoperative Incisional surgical site infection(I-SSI)in patients with colorectal cancer.Methods:A total of 531 patients with colorectal cancer who were treated by surgery in our department from December 2017 to December 2019 in the Department of gastrointestinal and colorectal surgery of China-Japan Union Hospital of Jilin University were selected as the research objects.According to the diagnostic criteria for nosocomial infection(test),the patients were divided into I-SSI group and Non-ISSI.group by retrospective analysis of the patient’s medical records,course records,laboratory examination,special examination and bacteriological examination.The following items were selected for analysis: age,gender,diabetes mellitus,preoperative ASA grade,body mass index(BMI),operation site,operation mode,operation time,intraoperative transfusion,subcutaneous drainage,etc.univariate analysis and multivariate logistic regression analysis were used to observe the correlation between various factors and operation site infection.Results:(1)A total of 531 cases met the inclusion and exclusion criteria,41 cases developed I-SSI,and the incidence rate of I-SSI was 7.7%.(2)Univariate analysis showed that aged patients,obesity(BMI ≥ 25 kg / m2),history of diabetes mellitus,history of abdominal surgery,preoperative radiotherapy and chemotherapy,preoperative intestinal perforation or obstruction,stoma formation,operation time ≥ 180 min and perioperative blood transfusion could significantly increase the incidence of I-SSI in colorectal cancer patients(P < 0.05).Subcutaneous drainage and laparoscopic surgery could significantly reduce the incidence of I-SSI The incidence of incision infection was reduced(P < 0.05);(3)Multivariate logistic regression analysis showed that patients with diabetes mellitus(or = 3.146,95% CI: 1.031-9.604,P = 0.044),history of abdominal surgery(or= 17.228,95% CI: 6.844-43.364,P < 0.01),preoperative radiotherapy and chemotherapy(or = 7.039,95% CI: 1.184-41.857,P = 0.032)and stoma(or = 24.672,95% CI: 1.184-41.857,P = 0.032)were found 578,P < 0.01);subcutaneous drainage(or = 0.306,95% CI: 0.122-0.770,P = 0.012)was an independent protective factor for I-SSI in colorectal cancer patients.Conclusion:Multivariate logistic regression analysis showed that diabetes mellitus,history of abdominal surgery,preoperative chemoradiotherapy and stoma formation were independent risk factors for I-SSI.after colorectal cancer surgery,and subcutaneous drainage was independent protective factor for I-SSI.