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Published on: January 27, 2019
Wound infection in pediatric surgery: a study in 1,094 neonates
1Regional Neonatal Surgical Unit, St. Mary's Hospital, Manchester, England.
Insights
Neonatal wound infection rates increased over time, with contaminated wounds showing higher infection risks. Key factors influencing infection include wound length, operation duration, and contamination during surgery.
Area of Science:
- Neonatal Surgery
- Infectious Disease Epidemiology
Background:
- Neonatal surgical site infections (SSIs) are a significant concern.
- Understanding risk factors for SSIs in neonates is crucial for improving outcomes.
Purpose of the Study:
- To analyze the incidence and risk factors of wound infections in neonates undergoing surgery.
- To identify trends in neonatal wound infection rates over a 12-year period.
Main Methods:
- Retrospective analysis of 1,433 surgical wounds in 1,094 neonates.
- Data collected from April 1975 to December 1987 at a regional neonatal surgical unit.
- Statistical analysis to determine associations between wound characteristics, operative factors, and infection incidence.
Main Results:
- Overall mean infection incidence was 16.6%, with a significant increase from 12.5% to 18.8% over the study period (P < .01).
- Contaminated wounds (20.7%) had higher infection rates than clean wounds (11.1%) (P < .001).
- Increased wound length, longer operation duration, and intraoperative contamination were significantly associated with higher infection rates (P < .001). Gestational age and birth weight did not influence infection rates.
Conclusions:
- Neonatal wound infection incidence has shown an upward trend.
- Surgical wound contamination, length, and duration are critical modifiable risk factors for neonatal infections.
- Staphylococcal species are the predominant pathogens in neonatal surgical site infections.
Abstract:
In an analysis of 1,433 wounds created in 1,094 neonates admitted to a regional neonatal surgical unit during the period April 1975 to December 1987, the mean incidence of infection was 16.6%. During this time there was an increase in the incidence of infection from 12.5% in the first 6 years to 18.8% in the last 7 years (P < .01). Contaminated wounds had an infection rate of 20.7%, whereas the rate in clean wounds was 11.1% (P < .001). Gestational age and birth weight had no influence on the incidence of wound infection. Increasing wound length (P < .001), increasing duration of operation (P < .001), and contamination at operation (P < .001) were all associated with a higher incidence of infection. Staphylococcal species were the most frequently isolated organisms from all categories of infected wounds (clean, potential, and actual contamination).
