Wound surveillance with ASEPSIS in colorectal surgery
Aydın Aktaş, Serdar Topaloğlu, Adnan Çalık, Mithat Kerim Arslan, Mustafa Öncü, İrfan Inci, Etem Alhan, Burhan Pişkin
Karadeniz Teknik Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Trabzon, Türkiye
Abstract
Purpose: Surgical site infections (SSIs) are a well-known complication of gastrointestinal surgery. The aims of this prospective cohort study are identifying risk factors associated with SSI and testing the utility of ASEPSIS wound surveillance method in colorectal surgery.
Materials and Methods: A prospective survey was carried out on 153 patients who underwent elective or emergency colorectal surgery from February to September 2007. Surveillance of the surgical wound was performed with NNIS (National Nosocomial Infections Surveillance System) and SENIC (The Study on the Efficacy of Nosocomial Infection Control) risk indexes and ASEPSIS methods.
Results: Twenty seven (17.6%) patients were suffering from SSI. Emergency colorectal surgery (p=0.034), absence of bowel preparation (p=0.034), preoperative hypoalbuminemia (p=0.003) and long operation time (p=0.012) were associated with SSIs. The independent factors were long operation time and preoperative hypoalbuminemia. Correlation between the NNIS risk index with the ASEPSIS was statistically significant (rs=0.017, p=0.035).
Conclusion: This study was limited to a tertiary referral practice of two general surgeons. Lack of laparoscopy and the small number of patients in the study group are also considered other limitations. The valuable role of NNIS index for prediction of SSI is verified. The ASEPSIS is found to be a simple, repeatable, and effective method for wound surveillance.
Keywords: Colorectal surgery, surgical site infection, wound surveillance, ASEPSIS, risk indexes for SSI