Blood transfusions and postoperative wound infection

Several studies have suggested an association between blood transfusions and infection in surgical patients. However, previous reports have not documented the relationship of transfusion to specific infection sites and have not adequately explored the importance of timing and type of blood product.

We reviewed the records of all patients undergoing operation for colon cancer at a large community hospital during the years 1974 to 1987. Data on hospital wound and other infections, wound infection risk factors, and type and timing of transfusions were analyzed.

Increased wound infection rates were associated with administration of both whole blood and packed red blood cells. However, multivariate analysis suggested that only the administration of packed red cells after operation independently predicted wound infections. Other independent variables were the presence of a colostomy and/or drain. A highly predictive model for wound infection was constructed with these three variables.

Blood transfusions, especially with packed red cells, after operation are an independent risk factor for wound infection.