Surgical site infection in elective operations for colorectal cancer after the application of preventive measures

Abstract

Objectives: To assess the prevalence of surgical site infection (SSI) after elective operations for colon and rectal cancer after the application of evidence-based preventive measures and to identify risk factors for SSI.

Design: Prospective, observational, multicenter.

Setting: Tertiary and community public hospitals in Catalonia, Spain.

Patients: Consecutive patients undergoing elective surgical resections for colon and rectal cancer during a 9-month period.

Main outcome measures: The prevalence of SSI within 30 days after the operations and risk factors for SSI.

Results: Data from 611 patients were documented: 383 patients underwent operations for colon cancer and 228 underwent operations for rectal cancer. Surgical site infection was observed in 89 (23.2%) colon cancer patients (superficial, 12.8%; deep, 2.1%; and organ/space, 8.4%) and in 63 (27.6%) rectal cancer patients (superficial, 13.6%; deep, 5.7%; and organ/space, 8.3%). For colon procedures, the following independent predictive factors were identified: for incisional SSI, open procedure vs laparoscopy; for organ/space SSI, hyperglycemia at 48 hours postoperatively (serum glucose level, >200 mg/dL), ostomy, and National Nosocomial Infection System index of 1 or more. In rectal procedures, no risk factors were identified for incisional SSI; hyperglycemia at 48 hours postoperatively (serum glucose level, >200 mg/dL) and temperature lower than 36°C at the time of surgical incision were associated with organ/space SSI.

Conclusion: The prevalence of SSI in elective colon and rectal operations remains high despite the application of evidence-based preventive measures.