Multivariate Analysis of Risk Factors for Wound Infection After Laparoscopic Colorectal Surgery

Joe Drosdeck, MD, Syed Husain, MBBS, Nilay Shah, MD, Andrew Suzo, BS, Alan Harzman, MD, Mark Arnold, MD

The Ohio State University Wexner Medical Center

Introduction
Surgical site infection is the most common complication after colorectal surgery. Laparoscopic colorectal surgery appears to lower the incidence of wound infection. The aim of this study is to identify the risk factors associated with surgical site infection after laparoscopic colorectal resection.

Methods
Patients undergoing colorectal resections at Ohio State University Medical Center between Jan 2006 and Dec 2012 were included in the study. Univariate and multivariate analyses were performed. The following variables were assessed: cancer, inflammatory bowel disease, BMI, diabetes, COPD, use of hand assistance, use of immunosuppressant medications, smoking and utilization of Pfannenstiel incision for specimen extraction.

Results
A total of 333 patients met inclusion criteria. The overall incidence of wound infection was 11%. A higher BMI, presence of IBD, and hand assist procedures were associated with a significantly higher risk of infection whereas use of a Pfannenstiel extraction site was associated with lower infection rates. Logistic regression model with significant predictors showed that these factors retained statistical significance. Odds ratio for wound infection with IBD, hand assistance and BMI (per unit increase) were 4, 2 and 1 respectively.

Conclusion
While most infections are associated with no modifiable risk factors, our study suggests that use of Pfannenstiel extraction site and avoidance of hand assistance may result in lower infection rates.


Session: Podium Presentation

Program Number: S053

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