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Risk Factors for Surgical-Wound Infection in General Surgery A Prospective Study

Published online by Cambridge University Press:  02 January 2015

Maxima Lizán-García ,
Juan García-Caballero  and
Angel Asensio-Vegas
Maxima Lizán-García*
Affiliation:
Unidad de Medicina Preventiva, Hospital General de Albacete, Spain
Juan García-Caballero
Affiliation:
Servicio de Medicina Preventiva, Hospital La Paz de Madrid, Spain
Angel Asensio-Vegas
Affiliation:
Servicio de Medicina Preventiva, Hospital Ramóny Cajal de Madrid, Spain
*
Unidad de Medicina Preventiva, Hospital General, C) Hermanos Falco s/n, 02006 Albacete, Spain
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Abstract

Objective:

To quantify surgical-infection rate, to assess adherence with the antibiotic prophylaxis protocol, and to identify independent factors associated with surgical-wound infection (SWI).

Methods:

We carried out a prospective study of a cohort of 2,237 general surgery patients with postsurgery stays of more than 48 hours. Odds ratios (OR) were estimated using unconditional multiple logistic regression.

Setting:

A 1,300-bed, university-affiliated, tertiarycare hospital in Madrid, Spain.

Results:

254 patients developed SWI. The rate of adherence to the antibiotic prophylaxis protocol was 63.5%. Eight factors were independently associated with risk of SWI: age (OR=1.2 for every 10 years of age); wound classification (clean-contaminated, OR=6.4; contaminated, OR=3.7; dirty or infected, OR=9.3); antimicrobial prophylaxis (OR=0.5); stay prior to surgery (OR=1.1 for every 3 days); duration of operation (OR=1.5 for every 60 minutes); malignant neoplasm (OR=1.7); emergency procedure (OR=1.99); intensive-care unit stay prior to surgery (OR=2.6); and antimicrobial prophylaxis administered 2 or more hours before operation (OR=5.3).

Conclusion:

In general, antimicrobial prophylaxis protects against SWI (OR=0.5); however, administration 2 hours or more before the operation increases the risk of SWI by a factor of 5.3. Therefore, measures should be taken to ensure the correct timing of antimicrobial prophylaxis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 5 , May 1997 , pp. 310 - 315
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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