Nosocomial abscess. Results of an eight-year prospective study of 32,284 operations
Related Experiment Video
Updated: Aug 16, 2026
Retroperitoneal Laparoscopic Debridement and Drainage for Pancreatic Abscess
Published on: March 15, 2024
1Department of Surgery, Veterans Administration Medical Center, Minneapolis, MN 55417.
Abstract:
This article details the results of 114 abscesses found after 32,284 operations during a 30-day prospective infection surveillance. Abscesses occurred more often after gastric/esophageal (3.6%), colonic/appendiceal (2.8%), and pancreatic/biliary (1.5%) operations. Abscesses were intra-abdominal (58%), pelvic/perineal (31%), and retroperitoneal (3%). The most common pathogens were Escherichia coli, enterococci, and Bacteroides organisms. Abscess symptoms appeared 10 +/- 6 days (mean +/- SEM) after surgery and were drained 8 +/- 8 days after onset of symptoms. Hospital stay from onset of symptoms to discharge was four times greater than that for wound infection. Twenty-seven patients (28%) died. Mortality was increased in patients older than 50 years and in those with renal failure or multiple abscesses. Nosocomial abscesses had a greater morbidity than would infection. Excessive expense and high mortality warrant infection surveillance for both wound infection and ongoing nosocomial abscesses.
Insights
Post-operative abscesses occurred in 114 of 32,284 patients, particularly after gastrointestinal surgeries. High morbidity and mortality underscore the need for infection surveillance to prevent these serious nosocomial infections.
Area of Science:
- Surgical Infections
- Infection Surveillance
- Nosocomial Pathogens
Background:
- Post-operative abscesses represent a significant complication following surgical procedures.
- Understanding the incidence, risk factors, and outcomes of these infections is crucial for patient care.
Purpose of the Study:
- To prospectively identify and analyze the occurrence, characteristics, and outcomes of post-operative abscesses.
- To evaluate the impact of nosocomial abscesses on patient morbidity, mortality, and hospital stay.
Main Methods:
- Prospective surveillance of 32,284 operations over 30 days.
- Detailed recording of abscess occurrence, location, pathogens, and patient demographics.
- Analysis of time to symptom onset, drainage, and hospital discharge.
Main Results:
- 114 post-operative abscesses were identified, with higher rates after gastric/esophageal, colonic/appendiceal, and pancreatic/biliary surgeries.
- Common pathogens included Escherichia coli, enterococci, and Bacteroides. Abscesses were most frequently intra-abdominal (58%).
- Symptoms appeared 10 days post-surgery, with a 28% mortality rate, increased in older patients and those with renal failure or multiple abscesses.
Conclusions:
- Post-operative abscesses contribute significantly to morbidity and mortality, exceeding that of wound infections.
- Effective infection surveillance for both wound infections and nosocomial abscesses is essential due to excessive costs and high mortality.
- Early detection and management are critical, as delayed drainage prolonged hospital stays and worsened outcomes.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Brain Abscess l: Introduction