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What is the effect of stoma construction on surgical site infection after colorectal surgery?
Rocco Ricciardi1, Patricia L Roberts, Jason F Hall
1Department of Colon and Rectal Surgery, Lahey Clinic, 41 Mall Road, Burlington, MA, 01805, USA, Rocco.Ricciardi@Lahey.org.
Introduction:
The aim of our study was to evaluate the effect of stoma creation on deep and superficial surgical site infections after an index colorectal surgical procedure.
Methods:
We designed a retrospective cohort study from the National Surgical Quality Improvement Program. We evaluated all patients who underwent colorectal surgery procedures from January 2005 to December 2009 with or without creation of a stoma and sought to identify the effect of stoma creation on deep and superficial surgical site infections.
Results:
A total of 79,775 patients underwent colorectal procedures (laparoscopic 30.7%, open 69.3%), while 8,113 patients developed a surgical site infection (10.2%). The univariate analysis revealed that surgical site infections were much more common in patients with a stoma compared to those with no stoma (11.8% vs. 9.5%, p < 0.0001). On multivariate analysis, stoma construction during the index colorectal procedure (OR 1.3, CI 1.2 to 1.4), ASA class ≥2, smoking, and abnormal body mass index were associated with surgical site infection.
Conclusions:
The construction of a stoma with colorectal procedures is associated with a higher risk of surgical site infection. Although the stoma effect on surgical site infection is attenuated with laparoscopic techniques, the association remained statistically significant.
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