Risk Factors for Surgical Site Infection after Laparoscopic Surgery for Colon Cancer

Surgical site infection (SSI) occurring as a complication after laparoscopic surgery for colon cancer causes patients pain and psychological stress, prolongs the hospital stay, and increases healthcare costs. The present study was designed to clarify the incidence of, and risk factors for, SSI after surgery for colon cancer.

The study group comprised 670 patients (370 male and 300 female; mean age, 67 y) who underwent laparoscopic surgery for colon cancer in our hospital from January 2010 through April 2015. Univariate and multivariable analyses were performed for 13 risk factors potentially related to post-operative SSI, including gender, age, body mass index, diabetes mellitus, American Society of Anesthesiologists (ASA) score, tumor location, pre-operative hemoglobin concentration, pre-operative serum albumin concentration, operation time, bleeding volume, tumor diameter, pathological stage, and type of sutures used for surgical site closure.

Surgical site infection occurred in 27 (4%) of the 670 patients. There was no surgery-related death. Univariate analysis of risk factors for SSI showed that the incidence of SSI was substantially lower in patients in whom Triclosan-coated PDS Plus(®) sutures were used for surgical site closure (1.8%, seven of 382 patients) than in those in whom Triclosan-uncoated PDS-II(™) sutures were used (6.9%, 20 of 288 patients; p = 0.0017). The incidence of SSI was substantially greater in patients who had diabetes mellitus (9.3%, seven of 75 patients) than in those who did not (3.4%, 20 of 595 patients; p = 0.0154). On multivariable analysis, only the non-use of triclosan-coated PDS Plus sutures was substantially related to SSI, with an odds ratio of 3.322 (p = 0.021) as compared with the use of triclosan-coated PDS Plus sutures.

To prevent SSI after laparoscopic surgery for colon cancer, triclosan-coated PDS Plus sutures should be used for abdominal closure.