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[Postoperative wound infections. III. Patient related risk factors]
1III Katedry i Kliniki Chirurgii Ogólnej Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Unlabelled:
A nosocomial infection is determined by plenty of factors, such as a kind of flora and its virulence, hygiene standard, efficacy of material and instruments sterilisation, technical terms of work organisation in hospital, and other staff and patient related factors. The aim of this study was to establish the risk factors of postoperative wound infection related to patient. The material was 1527 surgically treated patients in the 3rd Surgical Department of the Collegium Medicum of the Jagiellonian University during one year. 66 patients with wounds of the head and 7 patients who died within three days after surgery without any wound infection signs were excluded from the study population. The healing of each wound was observed during the patient's hospitalisation and 30 days after his discharge from hospital, and in orthopedic patients 6 months after discharge. The total number of 132 infected wounds was identified. The population of 1352 wounds healed without any complications was a control group. All the data were recorded in a Wound Infection Register Card and were collected in the computer database. The data were statistically analysed. Relationships between single factor and postoperative wound infection were evaluated using chi-square statistics and in the small group Fisher's exact probability test. Odds ratios and corresponding 95% confidence intervals were computed for all variables. The overall wound infection rate was 8.9%. The significant factors (p < 0.05) were radiotherapy prior to operation, malnutrition, renal failure, respirator treatment, colostomy, tracheostomy in contaminated wounds and neoplastic disease in dirty wounds. Antibiotic therapy and the presence of remote active infection at the time of operation were found also risk factors.
Conclusion:
Statistically significant risk factors of the postoperative wound infection related to patient's condition appeared malnutrition, radiotherapy prior to surgery, renal failure, artificial ventilation, presence of colostomy and coexisting another nosocomial infection at the operation.
Insights
Identifying patient-specific risk factors for postoperative wound infections is crucial for prevention. Malnutrition, prior radiotherapy, renal failure, and artificial ventilation significantly increase infection risk in surgical patients.
Area of Science:
- Medical Microbiology
- Surgical Infections
- Epidemiology
Context:
- Nosocomial infections pose a significant threat in healthcare settings.
- Patient-related factors play a critical role in the development of surgical site infections.
- Understanding these factors is essential for improving patient outcomes.
Purpose:
- To identify patient-specific risk factors associated with postoperative wound infections.
- To analyze the correlation between various patient conditions and the incidence of surgical site infections.
- To provide data for targeted prevention strategies.
Summary:
- A study of 1527 surgically treated patients identified a 8.9% overall wound infection rate.
- Significant risk factors included prior radiotherapy, malnutrition, renal failure, respirator treatment, colostomy, and coexisting infections.
- Neoplastic disease in dirty wounds and antibiotic therapy were also identified as risk factors.
Impact:
- Highlights key patient conditions that elevate the risk of postoperative wound infections.
- Informs clinical practice by identifying modifiable and non-modifiable risk factors.
- Aids in developing targeted interventions to reduce surgical site infection rates and improve patient safety.