2011, Number 4
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ABSTRACTBackground: The registration of cases of surgical site infection (SSI) for the period of hospitalization has a bias whose magnitude is not known in our environment. The aim of this study was to measure the incidence of SSI in primary interventions for patients using an ambulatory monitoring system.
Methods: We designed a cross-sectional, descriptive study of patients undergoing primary surgery. All patients were assessed at the 2nd, 7th and 21st day after surgery. We used criteria of wound infection according to the Centers for Disease Control and Prevention (CDC), Atlanta, GA. Comparison of variables was performed using χ2 and Fisher’s exact test. Analysis of variables related to the risk of SSI and the control variables was performed using logistic regression.
Results: Of 152 patients (107 males and 45 females), 32 were diagnosed with SSI at 48 h and at 7 and 21 days after surgery, respectively. The type of surgery (emergency), surgical risk according to the American Society of Anesthesiologists (ASA), duration of surgery, body mass index (BMI) and underlying diseases are predictors of SSI and were statistically significant (p ‹0.05). Culture was performed in 32 cases and Escherichia coli were isolated in 25%.
Conclusions: In this series of unselected patients, the incidence of SSI reached 21.1% after a 1-month minimum follow-up.
Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6:428-442.
Martone WJ, Jarvis WR, Culver DH, Haley RW. Incidence and nature of endemic and epidemic nosocomial infections. En: Bennett JV, Brachman PS, eds. Hospital Infections. 3rd ed. Boston: Little, Brown and Co; 1992. pp. 577-596.
Garner JS, Jarvis WR, Emori TG, Horan TC, Huges JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128-140.
Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TC. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control 1992;20:271-274.
Mangram AJ, Horan TC, Pearson ML, Silver RC, Jarvis WR. The Hospital Infection Control Practices Advisory Committee. Guideline for the prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:247-280.
Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991;91:72S-75S.
Kricek TJ, Robson MC. Evolution of quantitative bacteriology in wound management. Am J Surg 1975;130:579-584.
Altemeier WA, Culbertson WR, Hummel RP. Surgical considerationsof endogenous infectionssources, types and methods of control. Surg Clin North Am 1968;48:227-240.
Velasco E, Thuler LCS, Martins CAS, de Castro Dias LM, Conalves VMSC. Risk factors for infectious complications after abdominal surgery for malignant disease. Am J Infect Control 1996;24:1-6.
Lee JT. Surgical wound infections: surveillance for quality improvement. En: Fry DE, ed. Surgical Infections. Boston: Little, Brown and Co; 1995. pp. 145-159.
Howard JM, Baker WF, Culberston WR, Grotzinger PJ, Iovine VM, Keehn RJ, et al; National Academy of Sciences−National Research Council, Division of Medical Sciences. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and various other factors. Ann Surg 1964;160(suppl 2):1-192.
Emori TG, Culver DH, Horan TC, Jarvis WR, White JW, Olson DR, et al. National nosocomial infections surveillance system (NNIS): description of surveillance methods. Am J Infect Control 1991;19:19-35.
Ministerio de Sanidad y Política Social. Clasificación Internacional de Enfermedades CIE-9-MC. 2010 Versión 1.1-19/02/2010. Madrid: Servicio de Publicaciones del Instituto Nacional de la Salud. Disponible en http://www.msps.es/ecieMaps-2010/documents/cie9mcref_2010 html#_bottom
Promis G, Nacrur R. Infección quirúrgica en heridas limpias. Rev Chil Cir 1990;42:51-54.
Promis G, Villablanca L. Infección de la herida quirúrgica del Servicio de Cirugía del Hospital Félix Bulnes Cerda. Rev Chil Cir 2000;52:593-600.
Silva JJ, Parada M, Pérez P. Infecciones quirúrgicas: análisis descriptivo en 4225 egresos. Rev Chil Cir 1993;45:174-178.
Basset DCJ, Stokes KJ, Thomas WRG: Wound infection with Pseudomonas multivorans. A water-borne contaminant of disinfectant solutions. Lancet 1970;1:1118-1119.
Bibby BA, Collins BJ, Ayliffe GAJ. A mathematical model for assessing risk of postoperative wound infection. J Hosp Infect 1986;8:31-39.
Borst M, Collier C, Miller D. Operating room surveillance: a new approach in reducing hip and knee prosthetic wound infections. Am J Infect Control 1986;14:161-167.
Brabender W, Hinthorn DR, Asher M, Lindsey NJ, Liu C. Legionella pneumophila wound infection. JAMA 1983;250:3091-3092.
Bates T, Touquet VLR, Tutton MK, Mahmoud SE, Reuther WA. Prophylactic metronidazole in appendicectomy: a controlled trial. Br J Surg 1980;67:547-550.
Ballesta López C. Profilaxis Antibiótica en Cirugía. Madrid: Aran Ediciones; 1987. pp. 33-52, 53-59, 125-150.
Taylor EW, Byrne DJ, Leaper DJ. Antibiotic prophylaxis and open groin hernia repair. World J Surg 1997;21:811-815.
Taylor EW, Duffy K, Lee K, Hill R, Noone A, Macintyre I, et al. Surgical site infection after groin hernia repair. Br J Surg 2004;91:105-111.
Sanchez-Manuel FJ, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev 2004;18:CD003769.
Bailey IS, Karran SE, Toyn K, Brough P, Ranaboldo C, Karran SJ. Community surveillance of complications after hernia surgery. BMJ 1992;304:469-471.
Bringman S, Ramel S, Heikkinen TJ. Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein. Ann Surg 2003;237:142-147.
Aufenacker TJ, van Geldere D, van Mesdag T, Bossers AN, Dekker B, Scheijde E, et al. The role of antibiotic profilaxis in prevention of wound infection after open mesh repair of primary inguinal hernia: a multicenter double-blind randomized controlled trial. Ann Surg 2004;240:955-960.
Platt R, Zaleznik DF, Hopkins CC, Dellinger EP, Karchmer AW, Bryan CS, et al. Perioperative antibiotic prophylaxis for herniorraphy and breast surgery. N Engl Med 1990;322:153-160.
Lazorthes P, Chiotasso P, Massip P, Materre JP, Sarkissian M. Local antibiotic prophylaxis in inguinal hernia repair. Surg Gynecol Obstet 1992;175:569-570.
Yerdel MA, Akin EB, Dolalan S. Effect of single-dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh. Ann Surg 2001;233:26-33.
Simchen E, Rozin R, Wax Y. The Israeli study of surgical infection of drains and the risk of surgical wound infection in operations for hernia. Surg Gynecol Obstet 1990;170:331-337.