Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections

Luca Degrate, Mattia Garancini, Marta Misani, Silvia Poli, Cinzia Nobili, Fabrizio Romano, Laura Giordano, Vittorio Motta, Franco Uggeri

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: Surgical site infections (SSIs) are the most common infections in colorectal surgery. Although some studies suggest that rectal surgery differs from colon surgery for SSI incidence and risk factors, the National Nosocomial Infection Surveillance system categorizes all colorectal surgeries into only one group. The aim of this study was to determine incidence, characteristics, and risk factors of SSIs according to the subclassification of colorectal surgery into right colon surgery (RCS), left colon surgery (LCS), and rectum surgery (RS). Methods: From November 2005 to July 2009, all patients requiring colorectal resectioning were enrolled into our program. The outcome of interest was an SSI diagnosis. Univariate and multivariate analyses were performed to determine SSI predictors in each group. Results: Two hundred seventy-seven consecutive colorectal resections were analyzed. SSI rates were 8% in RCS, 18.4% in LCS, and 17.6% in RS. LCS and RS showed significantly higher SSI incidences (p∈=∈0.022) and greater rates of organ/space infections compared to RCS (p∈=∈0.029). Predictors of SSI were steroid use among RCS, age greater than 70 years, multiple comorbidities, steroid use, non-neoplastic colonic disease, urgent operation, ostomy creation, postoperative intensive care among LCS, preoperative chemoradiation, heart disease, and prolonged operation among RS patients. On multivariate analysis, the coupled LCS and RS groups showed an increased risk for SSI compared to RCS (OR, 2.57). Conclusions: SSI incidences, characteristics, and risk factors seem to be different among RCS, LCS, and RS. A tailored SSI surveillance program should be applied for each of the three groups, leading to a more competent SSI recognition and reduction of SSI incidence and related costs.

Original languageEnglish
Pages (from-to)61-69
Number of pages9
JournalInternational Journal of Colorectal Disease
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 2011

Fingerprint

Surgical Wound Infection
Colon
Rectum
Colorectal Surgery
Incidence
Multivariate Analysis
Steroids
Ostomy
Colonic Diseases

Keywords

  • Colon surgery
  • Hospital infection
  • Rectal surgery
  • Surgical site infection
  • Wound infection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections. / Degrate, Luca; Garancini, Mattia; Misani, Marta; Poli, Silvia; Nobili, Cinzia; Romano, Fabrizio; Giordano, Laura; Motta, Vittorio; Uggeri, Franco.

In: International Journal of Colorectal Disease, Vol. 26, No. 1, 01.2011, p. 61-69.

Research output: Contribution to journalArticle

Degrate, Luca ; Garancini, Mattia ; Misani, Marta ; Poli, Silvia ; Nobili, Cinzia ; Romano, Fabrizio ; Giordano, Laura ; Motta, Vittorio ; Uggeri, Franco. / Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections. In: International Journal of Colorectal Disease. 2011 ; Vol. 26, No. 1. pp. 61-69.
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T1 - Right colon, left colon, and rectal surgeries are not similar for surgical site infection development. Analysis of 277 elective and urgent colorectal resections

AU - Degrate, Luca

AU - Garancini, Mattia

AU - Misani, Marta

AU - Poli, Silvia

AU - Nobili, Cinzia

AU - Romano, Fabrizio

AU - Giordano, Laura

AU - Motta, Vittorio

AU - Uggeri, Franco

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AB - Purpose: Surgical site infections (SSIs) are the most common infections in colorectal surgery. Although some studies suggest that rectal surgery differs from colon surgery for SSI incidence and risk factors, the National Nosocomial Infection Surveillance system categorizes all colorectal surgeries into only one group. The aim of this study was to determine incidence, characteristics, and risk factors of SSIs according to the subclassification of colorectal surgery into right colon surgery (RCS), left colon surgery (LCS), and rectum surgery (RS). Methods: From November 2005 to July 2009, all patients requiring colorectal resectioning were enrolled into our program. The outcome of interest was an SSI diagnosis. Univariate and multivariate analyses were performed to determine SSI predictors in each group. Results: Two hundred seventy-seven consecutive colorectal resections were analyzed. SSI rates were 8% in RCS, 18.4% in LCS, and 17.6% in RS. LCS and RS showed significantly higher SSI incidences (p∈=∈0.022) and greater rates of organ/space infections compared to RCS (p∈=∈0.029). Predictors of SSI were steroid use among RCS, age greater than 70 years, multiple comorbidities, steroid use, non-neoplastic colonic disease, urgent operation, ostomy creation, postoperative intensive care among LCS, preoperative chemoradiation, heart disease, and prolonged operation among RS patients. On multivariate analysis, the coupled LCS and RS groups showed an increased risk for SSI compared to RCS (OR, 2.57). Conclusions: SSI incidences, characteristics, and risk factors seem to be different among RCS, LCS, and RS. A tailored SSI surveillance program should be applied for each of the three groups, leading to a more competent SSI recognition and reduction of SSI incidence and related costs.

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KW - Rectal surgery

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KW - Wound infection

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