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Predictors of intraoperative bacterial contamination and postoperative infection in elective colorectal surgery
1Department of Clinical Bacteriology, Kärnsjukhuset, Skövde, Sweden.
Abstract:
This prospective study of 238 patients undergoing colorectal operations attempted to identify the risk factors for intraoperative bacterial contamination and postoperative infection. The degree of contamination was assessed by the recovery of Enterobacteriaceae spp. or Staphylococcus aureus in peritoneal irrigation fluid using dip-slides. Uni- and multivariate analyses comprised 17 parameters. Intraoperative contamination was strongly associated with postoperative infection (P less than 0.001). Abdominal drains were correlated with contamination (P = 0.019), but not with infection. Decompressive colostomy was over-represented in patients with contamination (P less than 0.001) but contributed to infection independent of its association with contamination (P less than 0.05), as did advanced age (P less than 0.05).
Insights
Intraoperative bacterial contamination during colorectal surgery significantly increases the risk of postoperative infection. Factors like abdominal drains and decompressive colostomy contribute to contamination and infection risk.
Area of Science:
- Surgical Infection Prevention
- Colorectal Surgery
- Microbiology
Background:
- Postoperative infection remains a significant complication following colorectal operations.
- Identifying risk factors for intraoperative contamination is crucial for preventing surgical site infections.
Purpose of the Study:
- To identify risk factors associated with intraoperative bacterial contamination in patients undergoing colorectal surgery.
- To determine the relationship between intraoperative contamination and the development of postoperative infections.
Main Methods:
- Prospective study involving 238 patients undergoing colorectal operations.
- Bacterial contamination assessed via Enterobacteriaceae spp. or Staphylococcus aureus in peritoneal irrigation fluid using dip-slides.
- Uni- and multivariate analyses of 17 parameters to identify risk factors.
Main Results:
- Intraoperative bacterial contamination was strongly associated with postoperative infection (P < 0.001).
- Abdominal drains correlated with contamination (P = 0.019) but not infection.
- Decompressive colostomy and advanced age were independent risk factors for infection (P < 0.05).
Conclusions:
- Intraoperative contamination is a key predictor of postoperative infection in colorectal surgery.
- Decompressive colostomy and advanced age represent significant independent risk factors for infection, irrespective of contamination levels.