Risk Factors Of Surgical Site Infections After Colon Cancer

Objective:For the past few years, the morbidity and mortality of colorectal cancer kept rising trend, especially the colon cancer, so more and more patients come for radical cure. At present,the first choice for most patients with colon cancer is radical surgery± postoperative chemotherapy, but the incidence of surgical site infections after radical operation of colon cancer stay at a high level, which not only afflicts patients in physical and psychological, but also delays the best opportunity to postoperative chemotherapy. However, there is no clinical specification to reduce the risk of wound infection currently. This study aims to analyze the clinical epidemiological characteristics of patients with colon cancer radical surgery and select risk factors of surgical site infections postoperative, to provide reference for the prevention of colon cancer postoperative wound infection.Methods:A total of 176 cases of patients with colon cancer who underwent radical surgery in Qilu Hospital of Shandong University from January 2013 to December 2014 were included in this retrospective study. The clinical data were collected to identify the related clinical risk factors of wound infection after colon cancer radical surgery, including:Intestinal preparation PEG= 0; sodium dihydrogen phosphate= 1), enema (no= 0,yes= 1), level of preoperative albumin, perioperative antibiotics (pure cephalosporin, beta lactam, aminoglycoside= 0, plus the nitro imidazoles= 1), incision protector (no= 0, use=1), gender (female= 0, male=1), age, preoperative blood glucose, body weight, intraoperative chemotherapy (no= 0, use= 1), Rinse drug (no= 0, with metronidazole= 1), subcutaneous catheter(no=0,yes=1), tumor location (ascending colon= 1, transverse colon= 2, descending colon= 3, sigmoid colon= 4). The wound infection(yes or no) as the dependent variable, the medical records and laboratory data of patients were analyzed statistically, and the risk factors for wound infection after colon cancer were screened and multiariable Logistic regression equation is established.Results:(1)In the 176 patients, there are 37 cases wound infection, accounted for 21%;(2) The Single-factor analysis shows that the risk factors include:gender, intraoperative chemotherapy, subcutaneous catheter, Tumor location;(3)The multiariable logistic regression equation is:Y= 22.676+0.352* preoperative albumin-4.125* gender+0.132* weight-3.101* Rinse drug-1.432* subcutaneous catheter+tumor location (ascending:1.726,transverse:-19.282, descending:5.270, sigmoid colon:0)(4) Goodness-of-fit test results show that the degree of fitting of the equation is good. Iteration records show that the iterative process of equations is smooth and no obvious fluctuations.Conclusion:(1). The incidence of wound infection after colon cancer radical surgery is still high;(2)Female, rinsing leather without the nitro imidazoles antibiotics before skin suture, no subcutaneous drainage tube, the tumor in the ascending colon and descending colon are risk factors of wound infection postoperative, which can be as screening condition to select the susceptible populations.(3) The Logistic regression equation is:π=1/1+exp[-(-22.676+0.352* preoperative albumin -4.125* gender+0.132* weight -3.101* Rinse drug-1.432* subcutaneous catheter+tumor location (ascending:1.726,transverse:-19.282, descending:5.270, sigmoid colon:0))]. The critical point of πis 0.5If it is greater than 0.5,the of wound infection after colon cancer surgery is high; or else, the probability is low...