Risk Factors For Incisional Surgical Site Infections In Colorectal Cancer Patients

ObjectiveTo explore the risk factors and preventive methods for incisional surgicalsite infections (I-SSI) in colorectal cancer patients after surgery.Methods2425cases of patients with consecutive operation for colorectal cancerwhich are operated by the same surgical team in Colorectal Surgery Department inFujian Medical University Affiliated Union Hospital from January2000to February2014, then the patients were divided into the I-SSI group and the non-I-SSI groupaccording to the status of I-SSI. The perioperativeclinical data were comparedbetween the groups, then the multivariate logistic regression analysis was performedfor the independent risk factors of the I-SSI.Results(1) According to the included and excluded criteria,2385cases left. The I-SSIoccurred in77patients with the infection rate of3.2%.(2) Using a univariate analysis, a high body mass index(≥25Kg/m2),long duration ofoperation (≥240min),large incision (＞20cm),combineddevisceration,intraoperative blood transfusion,palliative operation,andpostoperative complications: anastomotic leakage, abdominal infection,pulmonary infection and urinary tract infectionwere identified to be the factorsincreasing the incidenceof I-SSI significantly. The laparoscopic surgery wasidentified to be the factordecreasingthe incidence of I-SSI significantly.(3) Using a multivariate analysis, the independent risk factors for I-SSI wereidentified to be a high body mass index(≥25Kg/m2)(OR2.85;95%CI,1.26~6.47,P=0.012), long duration of operation (≥240min)(OR2.29;95%CI,1.02~5.15,P=0.045), combined devisceration(OR3.08;95%CI,1.19~8.00, P=0.021) andpostoperativeabdominal infection (OR5.37;95%CI,1.41~20.50, P=0.014). Theindependent protective factor for I-SSI was identified to be the laparoscopic surgery(OR0.35;95%CI,0.13~0.94, P=0.038).Conclusion A high body mass index (≥25Kg/m2), long duration of operation (≥240min),combined devisceration and postoperative abdominal infection wereidentified to be the independent risk factors for I-SSI.High-risk patientshavingindependent risk factorsshould receiveindividualized perioperativeintervention.Nevertheless, the laparoscopic surgerycan decreasethe incidence of I-SSI.