SURGICAL SITE INFECTIONS AND RISK FACTORS IN ELECTIVE LAPAROTOMY
Dr. Taner ÇOLAK1, Dr. Hüseyin ALAKUŞ1, Dr. Okan ERDOĞAN1, Dr. Dilara ÖĞÜNÇ2, Dr. Mustafa AKAYDIN1
1Akdeniz Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Antalya
2Akdeniz Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalı, Antalya
Surgical-site infections (SSI) are the important caube of postoperative morbidity and mortality. The aim of this study is to estimate the incidence of SSI in elective laparotomy and identify risk factors for prevention of SSI. All patients who underwent elective laparotomy except transplantation and the operations that used prosthesis in a one-year period were included in the study. Patients were followed over the month following surgery. For each patient, data including patients' characteristics, operative factors, type of procedure and SSI occurrence were collected on a standardized form by a surgical staff committed for the study. SSI incidence was found to be 20% in 253 patients. Albumin b 3.2 g/dl, classification of the wound, procedure duration >2 hours, peritoneal drains, blood transfusion, median laparotomy incision, National Nosocomial Infection Surveillance (NNIS) score >1 and Study on the Efficacy of Nosocomial Infection Control (SENIC) score>1 were found to be risk factors for SSI by univariate analysis. Only median laparotomy incision (RR: 3.3, 95CI: 1.6-6.5) and NNIS score >1 (RR: 7.8, 95CI: 2.7-22.3) was found statistically important according to logistic regression analysis. Based on this surveillance data, infectious risk was high in elective surgery of the abdomen and associated with patients' comorbidity and duration of contamination. NNIS score was found more accurate than wound class for SSI risk in elective laparotomy. In spite of inadequate evidence, it could be suggested that blood transfusion, improper drainage and duration of procedure might be reduced in order to prevent SSI elective laparotomy.
Keywords: surgical site infections, elective laparotomy, risk factors, NNIS, SENIC