Related Experiment Video
Updated: Nov 24, 2025
Procurement for a Vascularized and Reinnervated Abdominal Wall Allotransplantation
Published on: July 18, 2025
Abdominal Wall Thickness is a Predictor for Surgical Site Infections in Patients Undergoing Colorectal Operations
Yu-Wei W Chang1,2, Kyle Murphy1,2, Daniel Yackzan1
1Department of Surgery, 12253University of Kentucky Medical Center, KY, USA.
Background:
Surgical site infections (SSIs) are an established complication following colorectal operations, with rates up to 30% reported in the literature. Obesity is a known risk factor for SSI; however, body mass index (BMI), body fat percentage, waist-hip ratio, or abdominal circumference are imperfect measures. The purpose of our study was to determine whether abdominal wall thickness (AWT) is predictive of SSI.
Methods:
We queried our American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database for patients (age ≥18 years) undergoing a colectomy at the University of Kentucky (UK) from January 1, 2013 to December 31, 2018. The exclusion criteria included patients with open abdomens or the lack of preoperative computed tomography (CT) within 3 months of their operation. AWT was measured at the level of the anterior superior iliac spine (ASIS) on abdominal CT. SSI was defined by superficial SSI, deep SSI, and wound dehiscence.
Results:
Of 1261 patients enrolled, 52.2% were female, with an average age of 57.4 years. More patients had laparoscopic operations (51%), and the median length of stay was 7 days. Our study demonstrated an SSI rate of 9.4% and a 30-day readmission rate of 11%. The overall mean AWT was 2.6 cm (range .1-13.1), and patients with the highest AWT quintile were more likely to develop an SSI than the lowest quintile (12% vs. 5%). After controlling for risk factors and confounders, the odds of an SSI were 3.6 times higher for patients with the highest AWT than patients with the lowest AWT.
Conclusions:
Among colorectal surgery patients, AWT is an independent risk factor predictive for SSI.
Insights
Abdominal wall thickness (AWT) independently predicts surgical site infections (SSIs) in colorectal surgery. Higher AWT increases SSI risk, offering a new metric beyond traditional obesity measures for patient assessment.
Area of Science:
- Colorectal Surgery
- Surgical Site Infections
- Medical Imaging
Background:
- Surgical site infections (SSIs) are a significant complication after colorectal surgery, affecting up to 30% of patients.
- Traditional obesity metrics like BMI are insufficient for predicting SSI risk.
- Abdominal wall thickness (AWT) is explored as a novel predictor.
Purpose of the Study:
- To determine if abdominal wall thickness (AWT) is a predictive factor for surgical site infections (SSIs) in patients undergoing colorectal surgery.
- To evaluate AWT as a potential metric for assessing SSI risk.
Main Methods:
- Retrospective analysis of 1261 patients undergoing colectomy from 2013-2018.
- Utilized the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database.
- Measured AWT on preoperative CT scans at the anterior superior iliac spine (ASIS) level.
Main Results:
- The overall SSI rate was 9.4%.
- Patients in the highest AWT quintile had a significantly higher SSI rate (12%) compared to the lowest quintile (5%).
- Increased AWT was independently associated with a 3.6-fold higher odds of developing an SSI, even after controlling for confounders.
Conclusions:
- Abdominal wall thickness (AWT) is an independent risk factor for SSIs in colorectal surgery patients.
- AWT provides a more precise measure of risk than conventional obesity indicators.
- This finding may aid in refining preoperative risk assessment and patient management strategies.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...