Modern Trends in Surgical Site Infection Rates for Colorectal Surgery: A National Surgical Quality Improvement...

Area of Science:

• Colorectal Surgery
• Surgical Site Infections
• Minimally Invasive Surgery

Background:

• Limited research exists on global trends in surgical site infection (SSI) rates for colorectal surgery over the past decade.
• Understanding these trends is crucial for improving patient outcomes and surgical practices.

Purpose of the Study:

• To analyze changes in SSI rates (superficial, deep, organ space) in colorectal resections from 2013 to 2020.
• To identify risk factors associated with SSI occurrence.
• To evaluate the impact of minimally invasive surgery (MIS) on SSI rates.

Main Methods:

• Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database (2013-2020).
• Inclusion of 279,730 patients undergoing open or laparoscopic colorectal resections.
• Statistical analysis using univariable and multivariable logistic regression.

Main Results:

• Significant decreases observed in superficial SSI rates (5.9% to 3.3%) and deep incisional SSI rates (1.4% to 0.6%).
• A notable increase in organ space SSI rates (5.2% to 7.1%).
• MIS adoption increased (59% to 66%) and was associated with significantly lower odds of all SSIs compared to open surgery (p < 0.01).

Conclusions:

• Superficial and deep incisional SSIs have declined, potentially due to increased MIS adoption and infection prevention bundles.
• Organ space SSIs continue to rise, necessitating further investigation into optimal bowel preparation and antibiotic strategies.
• Future research should focus on novel interventions to reduce postoperative infections.