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. 2021 Mar;23(3):724-731.
doi: 10.1111/codi.15420. Epub 2020 Nov 21.

The community burden of surgical site infection following elective colorectal resection

Lydia Newton  1 , Ffion Dewi  1 , Angus McNair  2 , Dawn Gane  1 , Jodie Rogers  1 , Harry Dean  1 , Anne Pullyblank  1
Affiliations

The community burden of surgical site infection following elective colorectal resection

Lydia Newton et al. Colorectal Dis. 2021 Mar.

Abstract

Aim: Surgical site infection (SSI) is common after colorectal surgery. Recent attempts to measure SSI have focused on inpatient SSI and readmissions. This study examined patient-reported SSI at 30 days over 8 years.

Methods: The Health Protection Agency questionnaire was used to prospectively measure 30-day patient-reported SSI in patients undergoing elective colorectal operations between February 2011 and April 2019. Questionnaires were sent by post and followed up with a phone call. Data relating to hospital stay were prospectively recorded on an enhanced recovery database.

Results: In all, 80.7% (1268) of 1559 patients responded to the questionnaire with an overall SSI rate of 15.9% (201/1268). The majority of patients who reported SSI presented in the community (66.7%) of whom 65% consulted their general practitioner and 35% saw a community nurse. Patient-reported SSI was validated by a health professional in over 90% of cases. Overall, only 1.5% of readmissions and 2% of ward attendances were due to an isolated wound problem. Patients who developed SSI during their index admission had a longer length of stay (11 days vs. 4 days) but there was no difference in delayed discharge or complications between patients with and without SSI, suggesting that a previously described association between SSI and increased length of stay may be due to observational bias.

Conclusion: Existing surveillance audits are suboptimal for monitoring SSIs following colorectal surgery as most SSIs present after discharge. There is a need for robust 30-day surveillance with a standardized methodology if comparisons are to be made between units.

Keywords: colorectal cancer; elective colorectal resection; surgical site infection.

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References

REFERENCES

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