Related Experiment Video
Updated: Sep 12, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Increasing Differences in Surgical Site Infections After Emergency and Elective Colorectal Surgery
Kevin Sun1, Chen Chia Wang1, Timothy M Geiger2
1Vanderbilt University School of Medicine, Nashville, Tennessee.
Introduction:
Surgical site infections (SSIs) are a significant source of morbidity and cost following colorectal surgery. We sought to determine trends in SSI incidence following elective and emergency colorectal surgery, hypothesizing stagnant rates in emergency surgeries due to slower adoption of minimally invasive surgery (MIS).
Methods:
We retrospectively analyzed 229,167 patients undergoing colectomy from 2011 to 2021 using the National Surgical Quality Improvement Program database. The primary outcome was trends in SSI rates following elective and emergency cases. Joinpoint regression calculated annual percent changes.
Results:
We analyzed 203,622 elective and 16,545 emergency colorectal surgeries. While the rate of any SSI following elective colorectal surgery declined significantly, no change was observed in emergency surgery. When comparing types of SSI, superficial SSI decreased at a greater rate in elective surgery compared to emergency surgery. Deep SSI decreased significantly for elective but not emergency surgery. Organ space SSI increased at a greater rate in emergency surgery. Upon subanalysis, the use of MIS increased at a greater rate in emergency surgery. Elective MIS maintained a significant downtrend in any, superficial, and deep SSIs, while emergency MIS did not show any significant trends.
Conclusions:
There is an increasing difference in SSI rates between emergency and elective colorectal surgery. Emergency cases show no significant change in any or deep SSI rates, smaller declines in superficial SSIs, and a greater increase in organ space SSIs compared to elective cases. This difference persists despite greater MIS utilization in emergency surgery and between emergency and elective MIS.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.