Determinants of wound infection in gastrointestinal operations: the Israeli study of surgical infections

Risk factors for wound infection in operations involving the opening of the gastrointestinal (GI) tract, were explored in a prospective study. There were 813 consecutive operations performed during a period of 9-14 months in 11 Israeli hospitals. The total crude infection rate was 21.6%, and the respective rates for operations on the stomach, small bowel and colon were 14.8, 21.4 and 25.4%. Of 17 putative risk factors, the strongest predictor was the performance of 2 or more operations during the same admission. Other significant risk factors were: a diagnosis of intestinal obstruction or perforation, introduction of an open drain, emergency admission, age over 40, hospital stay prior to surgery 7 or more days, urinary catheter and infection on admission. Adjustment for these factors in a logistic regression model reduced the effect of the anatomical site of the operation (i.e. large bowel vs stomach) to a non-significant level.