Preventing surgical-site infections after colorectal surgery

Surgical-site infection (SSI) is a major contributor to patient mortality rates and health care costs. Due to the high risk of bacterial contamination, colorectal surgery is associated with a particularly high risk of postoperative infection. The surveillance reported here was conducted at Aichi Medical University Hospital on 304 patients who underwent elective colorectal resection--total or partial--from June 2006 to May 2009. To determine risk factors for SSI, multivariate analysis was used. Forty-six (15.1%) patients were diagnosed with SSI. Patients who received cefotiam for prophylaxis showed the highest incidence of SSI (26.6%), and patients who were administered flomoxef showed the lowest incidence (8.1%). Patients who developed SSI were more likely to intraoperative blood loss (308.1 ± 29.8 vs. 153.9 ± 12.2; p < 0.05), longer postoperative antimicrobial administration (5.3 ± 2.2 vs. 4.5 ± 1.5; p < 0.05), and longer operative time (3.3 ± 1.6 vs. 2.7 ± 1.2; p < 0.05). Intraoperative bleeding, antimicrobial choices to cover both anaerobic and aerobic bacteria, and length of antimicrobial administration were independently predictive of SSI development according to multivariate logistic regression analysis. These results suggest that the degree of operative invasion and anaerobic bacteria contribute to SSI following colorectal surgery.