[Surveillance of surgical site infections after digestive surgery]

The authors had for aim to monitor surgical site infections (SSI) after digestive surgery and to compare local hospital rates to those of the south-east French region. The overall rate of SSI was compared to the rate of two targeted surgeries: cholecystectomy and hernia repair (CHOL, HERN).

Surveillance of all surgical procedures, following "CCLIN Sud-Est" surveillance guidelines was carried out between June and August 2006.

Three hundred and thirty-eight surgeries were included. Among them, 20 SSIs (5.92%) were diagnosed and confirmed by a surgeon. The univariate analysis identified six risk factors: age, wound classes (3 or 4), ASA (3 or 4 or 5), length of surgery (greater than two hours), complexity of surgery, and carcinologic surgery. In the multivariate analysis, ASA score and length of surgery were significantly linked to SSI. SSI rates for HERN and CHOL were respectively 2.7 (2/73) and 2.9% (2/68).

The overall rate of infection was high compared to the "CCLIN Sud-Est" 2005 data. However, teaching hospitals accounted for only 8% of all interventions and they usually hospitalize patients at risk. Thus, the overall follow-up requires stratifying the results in homogeneous groups of patients (NNIS) to have comparable results overtime and between hospitals. In addition, this monitoring is difficult to perform because it is a very time-consuming routine. However, if CHOL and HERN are more reliable for comparison and less time-consuming, they do not reflect the overall rate of SSI.