Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;6(3):189-194.
doi: 10.1093/gastro/goy007. Epub 2018 Apr 30.

Incidence and risk factors for incisional surgical site infection in patients with Crohn's disease undergoing bowel resection

Tuo Hu  1   2 , Xianrui Wu  1   2 , Jiancong Hu  1   2 , Yufeng Chen  1   2 , Huashan Liu  1   2 , Chi Zhou  1   2 , Xiaowen He  1   2 , Min Zhi  3 , Xiaojian Wu  1   2 , Ping Lan  1   2
Affiliations

Incidence and risk factors for incisional surgical site infection in patients with Crohn's disease undergoing bowel resection

Tuo Hu et al. Gastroenterol Rep (Oxf). 2018 Aug.

Abstract

Background: Patients with Crohn's disease (CD) are often reported to be at a high risk for incisional surgical site infection (SSI). The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection.

Method: CD patients undergoing bowel resection between 2007 and 2015 were enrolled. Demographic and clinical features related to post-operative incisional SSI were analysed using both univariate and multivariate logistical analyses.

Results: Of all eligible patients (n = 159), 123 (77.4%) were male, with a mean age at surgery of 33.4 ± 11.8 years. A total of 35 (22.0%) CD patients developed post-operative incisional SSI. Post-operative incisional SSI was more likely to happen in patients who had penetrating type of disease (P = 0.018), underwent bowel resection for the indication of chronic fistula (P = 0.005) and had an intra-operative finding of fistula (P = 0.001). A greater proportion of patients with post-operative incisional SSI were found to have anemia (P = 0.019) but elevated levels of white blood cells (P = 0.027), neutrophils (P = 0.006) as well as an elevated percentage of neutrophils (P = 0.005). Multivariate logistic regression analysis showed that anemia (odds ratio [OR]: 3.31, 95% confidence interval [CI]: 1.05-10.46, P = 0.041), an elevated percentage of neutrophils (OR: 2.85, 95% CI: 1.23-6.59, P = 0.014) and an intra-operative finding of fistula (OR: 3.76, 95% CI: 1.53-9.21, P = 0.004) were significantly associated with the risk for post-operative incisional SSI.

Conclusions: Anemia, elevated percentage of neutrophils and intra-operative finding of fistula are predictors for the development of post-operative incisional SSI in CD patients undergoing bowel resection. Favorable pre-operative nutrition status and low inflammatory status may lessen the incidence of post-operative incisional SSI.

Keywords: Crohn’s disease; bowel resection; incisional surgical site infection; risk factors.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Peyrin-Biroulet L, Oussalah A, Williet N. et al. Impact of azathioprine and tumour necrosis factor antagonists on the need for surgery in newly diagnosed Crohn’s disease. Gut 2011;60:930–6. - PubMed
    1. Bernell O, Lapidus A, Hellers G.. Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn’s disease. Br J Surg 2000;87:1697–701. - PubMed
    1. Bouguen G, Peyrin-Biroulet L.. Surgery for adult Crohn’s disease: what is the actual risk? Gut 2011;60:1178–81. - PubMed
    1. Lightner AL, Shen B.. Perioperative use of immunosuppressive medications in patients with Crohn's disease in the new ‘biological era’. Gastroenterol Rep (Oxf) 2017;5:165–77. - PMC - PubMed
    1. Lightner AL, McKenna NP, Tse CS. et al. Postoperative outcomes in ustekinumab-treated patients undergoing abdominal operations for Crohn’s disease. J Crohns Colitis 2017; doi:10.1093/ecco-jcc/jjx163. - PubMed

LinkOut - more resources