scholarly journals GAMBARAN KEJADIAN INFEKSI LUKA OPERASI (ILO) PASCA BEDAH ABDOMEN DI RSUD ABDUL WAHAB SJAHRANIE SAMARINDA

2020 ◽  
Vol 8 (1) ◽  
pp. 21-37
Author(s):  
Sepriani indriati Azis ◽  
P.M.T. Mangalindung Ompusunggu ◽  
Hadi Irawiraman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Staphylococcus Epidermidis ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Surgical Wound ◽  
Duration Of Surgery

Infeksi luka operasi (ILO) adalah infeksi pada bagian tubuh yang terpapar oleh ahli bedah saat prosedur invasive. ILO merupakan salah satu infeksi nosokomial yang paling umum dan paling dapat dicegah diantara infeksi nosokomial lainnya, namun kejadian infeksi luka operasi terutama pada bedah abdomen masih menunjukkan beban yang signifikan. Faktor resiko infeksi luka operasi meliputi usia tua, jenis luka operasi, penyakit penyerta seperti diabetes mellitus, pemberian antibiotik profilaksis yang tidak adekuat, status gizi pasien seperti obesitas dan malnutrisi serta durasi operasi yang panjang. Penelitian ini bertujuan untuk mengetahui gambaran kejadian infeksi luka operasi pasca bedah abdomen di RSUD Abdul Wahab Sjahranie Samarinda. Metode penelitian ini adalah penelitian deskriptif laboratorik. Data penelitian diambil dari swab luka operasi dan data rekam medik pada 40 pasien pasca bedah abdomen yang melakukan pergantian perban pertama kali serta memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan 30 orang (75%) pasien mendapatkan infeksi luka operasi. Mayoritas pasien terinfeksi berusia diatas 40 tahun, yaitu pada 15 pasien (37,5%). Sebagian besar pasien terinfeksi mendapatkan luka bersih terkontaminasi, yaitu 23 pasien (57,5%). Mayoritas pasien terinfeksi yaitu 27 pasien (67,5%) tidak memiliki penyakit penyerta. Bakteri gram positif, yaitu Staphylococcus epidermidis merupakan bakteri penginfeksi terbanyak yang teridentifikasi pada 10 orang (33,3%) pasien. Seluruh pasien terinfeksi, yaitu 30 pasien (75%) mendapatkan antibiotik profilaksis. Mayoritas pasien terinfeksi memiliki status gizi normal, yaitu 17 orang (42,5%), dan kejadian infeksi lebih banyak terjadi pada pasien dengan durasi <120 menit, yaitu 20 orang (50%) pasien.   Kata Kunci : Infeksi Luka Operasi, ILO, Bedah Abdomen, Faktor Resiko Infeksi Luka Operasi Surgical site infection (SSI) is an infection at the part of the body that was exposed by a surgeon during an invasive procedure. SSI is one of the most common and most preventable nosocomial infection among other nosocomial infections, but the incidence of surgical site infections especially in abdominal surgery still shows a significant burden. Risk factors of surgical site infections include old age, type of surgical wound, comorbidities such as diabetes mellitus, inadequate prophylactic antibiotics, nutritional statuses such as obesity and malnutrition and long duration of surgery. This study aimed to explain an overview of the incidence of postoperative abdominal wound infection in Abdul Wahab Sjahranie General Hospital, Samarinda. This research method was a laboratory descriptive study. The research data was taken from surgical wound swabs and medical record data of 40 post-abdominal surgery patients who made the bandage changes for the first time and met the inclusion and exclusion criteria. The results showed 30 patients (75%) had surgical site infections. The highest percentage of infected patients aged over 40 years, i.e. in 15 people (37.5%). Most of the infected patients had clean contaminated wounds, i.e. in 23 patients (57.5%). The majority of infected patients did not have concomitant diseases,  i.e. 27 people (67.5%). Gram-positive bacteria, specifically Staphylococcus epidermidis was the most infectious bacteria identified in 10 patients (33.3%). All infected patients, i.e. 30 patients (75%) received prophylactic antibiotics. The highest frequencies of infected patients had normal nutritional status, i.e.17 patients(42.5%), and the incidence of infection was more common in patients with duration <120 minutes, i.e. 20 patients (50%). Keywords : Surgical Site Infection, SSI, Abdominal Surgery, Risk Factors

scholarly journals Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical College ◽  
Related Risk ◽  
Microbiological Methods ◽  
Duration Of Surgery ◽  
History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

scholarly journals Evaluation of patient related modifiable and non-modifiable risk factors in causation of surgical site infection in various abdominal surgeries

2018 ◽  
Vol 6 (1) ◽  
pp. 265
Author(s):  
Abhinav Agrawal ◽  
Shivam Madeshiya ◽  
Roshni Khan ◽  
Shashank S. Tripathi ◽  
Gaurav Bharadwaj
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Signs And Symptoms ◽  
Blood Transfusions ◽  
Site Infection ◽  
Case Scenario ◽  
Related Risk ◽  
Duration Of Surgery ◽  
Before And After

Background: Surgical Site Infection (SSI) is second commonest nosocomial complication in surgical speciality. Majority of surgical wounds are contaminated by microbes, but in most cases, infection does not develop because innate host defense are quite efficient in elimination of contaminants. The objective of this study was to evaluate patient related risk factors in causation of surgical site infection in various abdominal surgeries.Methods: All patients who admitted in surgical OPD/emergency and undergoing abdominal surgical procedures were included in study. This observational study was comprised of 952 subjects. Patients were observed in wards and during follow up to assess signs and symptoms of surgical site infection.Results: Result were analysed in terms of age, sex, distribution of cases based on case scenario (elective v/s emergency), wound class, type of surgery (laparoscopic v/s open), smoking, diabetes, duration of surgery, complete hemogram before and after blood transfusion, number of blood transfusions, albumin, blood sugar level, discharge from surgical site, number of days of drains, stoma  and hospital stay.Conclusions: Surgical site infection in emergency cases were found to be higher as compared to elective cases. Occurrence of SSI proportionately increased with degree of contamination, duration of surgery and age of patients. Laparoscopic procedures showed fewer incidences of surgical site infection as compared to open procedures. Various factors showed statistically significant association with surgical site infections were diabetes, smoking, blood transfusions, haemoglobin and albumin levels. Presence of stomas and drains were associated with increased incidence of SSI but could not be proven statistically.

scholarly journals The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lijun Li ◽  
Hongyan Cui
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Blood Loss ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Enterococcus Faecalis ◽  
Urinary Catheter ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Duration Of Surgery

Abstract Background Surgical site infections after cesarean section are very common clinically, it is necessary to evaluate the risk factors of surgical site infections after cesarean section, to provide evidences for the treatment and nursing care of cesarean section. Methods This study was a retrospective cohort study design. Patients undergone cesarean section in a tertiary hospital of China from May 2017 to May 2020 were identified, we collected the clinical data of the included patients, and we analyzed the infection rate, etiological characteristics and related risk factors of surgical site infection after caesarean section. Results A total of 206 patients with cesarean section were included, and the incidence of surgical site infection in patients with cesarean section was 23.30%. A total of 62 cases of pathogens were identified, Enterococcus faecalis (33.87%) and Escherichia coli (29.03%) were the most common pathogens. Both Enterococcus faecalis and Escherichia coli were highly sensitive to Cefoperazone, Meropenem, and Levofloxacin. Logistic regression analyses indicated that Age ≥ 30y (OR 4.18, 95%CI: 1.23–7.09), BMI ≥ 24 (OR 2.39, 95%CI: 1.02–4.55), duration of cesarean section ≥ 1.5 h (OR 3.90, 95%CI: 1.28–5.42), estimated blood loss ≥ 400 ml (OR 2.35, 95%CI: 1.10–4.37) and the duration of urinary catheter ≥ 24 h (OR 3.18, 95% CI: 1.21–5.71) were the independent risk factors of surgical site infection after cesarean section (all p < 0.05). Conclusions Age, BMI, duration of surgery, blood loss and urinary catheter use were associated with higher risk of the surgical site infection after cesarean section. Clinical preventions and interventions are warranted for those population to reduce the occurrence of surgical site infection.

scholarly journals Factors predicting surgical site infection after clean contaminated surgery

2017 ◽  
Vol 5 (1) ◽  
pp. 300
Author(s):  
Ranjith Mannarakkal ◽  
Mohammed Suaib ◽  
Abidali Karatparambil ◽  
Abhijith N. Das
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Prolonged Exposure ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
E Coli ◽  
Co Morbidity ◽  
Abdominal Operations ◽  
Clean Contaminated

Background: The infection of a wound is defined as the invasion of organisms through tissues following a breakdown of local and systemic host defences, leading to cellulitis, lymphangitis, abscess and bacteraemia. Southampton criteria and the centers for disease control and prevention criteria for the diagnosis of surgical site infections are used now for severity assessment. There is still controversy existing on the multifactorial causal relationship.Methods: Longitudinal Observational study with nonrandom purposive sampling carried out in the patients in OT, Casuality, ICU and Wards, in our hospital having clean contaminated abdominal operations for one-year period starting from November 2015 determine the factors responsible for surgical site infections following clean contaminated abdominal operations with prophylactic antibiotics(n=150).Results: Diabetes mellitus (odds ratio of 1.9) and emergency procedure (12.6%) were the most important risk factors for development of SSI. E. Coli (45%, n= 9) was the most common organism. Midline incision (n=6/22 = 27.27%) showed highest rate. Other high-risk factors are obesity, malnutrition, anemia, old age and prolonged duration of surgeries.Conclusions: Various host factors like malnutrition, obesity, patients knowledge about hygiene, presence of co-morbidity etc. coupled with environmental factors such as condition of the wounds, delay to initiate operation, duration of operation, prolonged exposure of peritoneal cavity to environment, prophylactic use of antibiotics and factors associated with surgery like type of incision, type of operation and experience of operating surgeon greatly contribute to occurrences of SSI. So, quality of surgical care including immediate assessment of patients, resuscitative measures, adequate preparation of patients and aseptic environment are important for control of SSI. Moreover, in absence of highly advanced surgical amenities, preoperative resuscitative units, modern operation theatre facilities and sophisticated sterilization procedure it is necessary to use prophylactic antibiotics to encounter the various types of micro-organisms responsible for surgical site infection, particularly E. coli.

scholarly journals Assessment of risk factors for surgical site infection following caesarean section

2019 ◽  
Vol 8 (11) ◽  
pp. 4518
Author(s):  
Aditi Sangwan ◽  
Vani Malhotra
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Emergency Caesarean ◽  
Group I ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Wound Discharge ◽  
Group Ii

Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus.      Mean duration of resuturing was 17.42±6.98 days.  Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.

scholarly journals 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Túlio Alves Jeangregório Rodrigues ◽  
Guilherme Fernandes de Oliveira ◽  
Júlia G C Dias ◽  
Laís Souza Campos ◽  
Letícia Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Exploratory Laparotomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Site Infection ◽  
The Impact

Abstract Background Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of SSI in the hospital length of stay and hospital mortality? (c) What are risk factors for SSI after exploratory abdominal surgery? Methods A retrospective cohort study assessed meningitis and risk factors in patients undergoing exploratory laparotomy between January 2013 and December 2017 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. 26 preoperative and operative categorical and continuous variables were evaluated by univariate and multivariate analysis (logistic regression). Outcome variables: Surgical site infection (SSI), hospital death, hospital length of stay. Variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%. Results A sample of 6,591 patients submitted to exploratory laparotomy was analyzed (SSI risk = 4.3%): Hospital length of stay in noninfected patients (days): mean = 16, median = 6, std. dev. = 30; hospital stay in infected patients: mean = 32, median = 22, std. dev. = 30 (P < 0.001). The mortality rate in patients without infection was 14% while hospital death of infected patients was 20% (P = 0.009). Main risk factors for SSI: ügeneral anesthesia (SSI = 4.9%, relative risk – RR = 2.8, P < 0.001); preoperative hospital length of stay more than 4 days (SSI=3.9%, RR=1.8, P = 0.003); wound class contaminated or dirty (SSI = 5.4%, RR = 1.5, P = 0.002); duration of procedure higher than 3 hours (SSI = 7.1%, RR = 2.1, P < 0.001); after trauma laparotomy (SSI = 7.8%, RR = 1.9, P = 0.001). Conclusion We identified patients at high risk of surgical site infection after exploratory laparotomy: trauma patients from contaminated or dirty wound surgery, submitted to a procedure with general anesthesia that last more than 3 hours have 13% SSI. Patients without any of these four risk factors have only 1.2% SSI. Disclosures All authors: No reported disclosures.

scholarly journals A study to assess the risk factors of surgical site infection among mother underwent cesarean section

2020 ◽  
Vol 11 (4) ◽  
pp. 5234-5237
Author(s):  
Parimala L ◽  
Prathiba P
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Emergency Surgery ◽  
Assessment Scale ◽  
Infection Prophylaxis ◽  
Site Infection ◽  
Previous Surgery ◽  
Site Assessment

Surgical site infection (SSI) is the second most normal irresistible inconvenience after urinary tract disease following cesarean section (CS). Surgical site infection after a cesarean area is related with expanded maternal horribleness, delayed emergency clinic remain and expanded clinical expenses. The hazard for creating SSI has noteworthily diminished over the three decades, fundamentally inferable from progress in cleanliness condition anti-infection prophylaxis, sterile methodology and other practice. Despite this decrease, the occurrence of surgical site infection is expected in the continuous rise in the incidence of cesarean delivery. A quantitative approach with descriptive study design was chosen to assess the risk factor of surgical site infection among mothers who underwent cesarean section at Saveetha Medical College Hospital. Sixty mothers who fulfil inclusive criteria were selected by purposive sampling technique. Sociodemographic variables were collected by semi-structured questionnaire, and the risk factors were assessed by surgical site assessment scale. The result of the study shows that 22(36.6%) of the mothers were obese, 34 (56.6%) were anaemia, 22 (36.6%) had hypertension, 7 (11.6%) had diabetes mellitus,37 (61.6%) were prolonged hospitalized, 9(15%) of study subject had previous surgery and 18 (30%) of study subject had emergency surgery. The surgical site assessment scale reveals that 31(51.6%) comes under the no-risk category,29(48.3 %) comes under the risk among preoperative mothers, and 22(36.6%) comes under no risk, 38 (63.3 %) comes under risk among post-operative mothers who underwent cesarean section. Thus the factors such as anaemia, hypertension, diabetes mellitus, prolonged hospital stay, previous surgery, and emergency surgery increase the risk for surgical site infection among mothers who underwent cesarean section.

scholarly journals An observational study of incidence of surgical site infections in gastrointestinal surgeries

2021 ◽  
Vol 8 (12) ◽  
pp. 3595
Author(s):  
Jenishkumar Vijaykumar Modi ◽  
Darshit Kalaria
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Surgical Site Infection Rate ◽  
Long Time ◽  
Surgery Department

Background: This study analysed the incidence of surgical site infections in gastrointestinal surgeries and its risk factors. so this study helped us in reducing surgical site infection by avoiding or minimizing that risk factors.Methods: The present study was conducted at general surgery department, SMIMER, Surat. An observational study of 400 cases that have undergone abdominal surgery in SMIMER hospital and were followed up from the day of operation to 30 days after discharge was done.Results: The overall infection rate for a total of the 400 cases was 17.25%. The incidence rate in this study was well within the infection rates of 2.8% to 17% seen in other studies. Different studies from India at different places have shown the SSI (surgical site infection) rate to vary from 6.09% to 38.7%.Conclusions: Our study reveals that though SSIs have been widely studied since a long time, they still remain as one of the most important causes of morbidity and mortality in surgically treated patients.

scholarly journals Surgical Site Infection After Emergency Abdominal Surgery in China: A Multicenter Prospective Study

2020 ◽  
Author(s):  
Ze Li ◽  
Hui Li ◽  
Pin Lv ◽  
Xingang Peng ◽  
Changliang Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Secondary Outcome ◽  
Microbial Culture ◽  
Site Infection ◽  
High Blood Glucose ◽  
Emergency Abdominal Surgery

Abstract Background There is still a lack of relevant studies on surgical site infection (SSI) after emergency abdominal surgery (EAS) in China. This study aims to understand the status of SSI after EAS in China and discuss its risk factors. Materials and Methods All adult patients who underwent EAS in 47 hospitals in China from May 1 to 31, 2018, and from May 1 to June 7, 2019, were enrolled in this study. The basic information, perioperative data, and microbial culture results of infected incision were prospectively collected.The primary outcome measure was the incidence of SSI after EAS, and the secondary outcome variables were postoperative length of stay, ICU admission rate, ICU length of stay, 30-day postoperative mortality, and treatment costs. Univariate and multivariate logistic regression were used to analyze the risk factors.Results A total of 953 patients (age 48.8 ± 17.9 years, male 51.9%) with EAS were included in this study: 71 patients (7.5%) developed SSI after surgery.The main pathogen of SSI was Escherichia coli (culture positive rate 29.6%). Patients with SSI had significantly longer overall hospital (p < 0.001) and ICU stays (p < 0.001), significantly higher ICU admissions (p < 0.001), and medical costs (p < 0.001) than patients without SSI.Multivariate logistic regression analysis showed that male (P = 0.010), high blood glucose level (P < 0.001), colorectal surgery (P < 0.001), intestinal obstruction (P = 0.045) and surgical duration (P = 0.007) were risk factors for SSI, whereas laparoscopic surgery (P < 0.001 = 0.022) was a protective factor. Conclusion This study found a high incidence of SSI after EAS in China. The occurrence of SSI prolongs the patient's hospital stay and increases the medical burden. The study also revealed predictors of SSI after EAS and provides a basis for the development of norms for the prevention of surgical site infection after emergency abdominal surgery.

Persistent Postoperative Hyperglycemia as a Risk Factor for Operative Treatment of Deep Wound Infection After Spine Surgery

Neurosurgery ◽  
2019 ◽  
Vol 87 (2) ◽  
pp. 211-219
Author(s):  
Zach Pennington ◽  
Daniel Lubelski ◽  
Erick M Westbroek ◽  
A Karim Ahmed ◽  
Peter G Passias ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Surgical Site Infection ◽  
Wound Infection ◽  
Glucose Control ◽  
Surgical Site Infections ◽  
Operative Management ◽  
Diabetic Patients ◽  
Site Infection ◽  
Glucose Levels

Abstract BACKGROUND Surgical site infections (SSIs) affect 1% to 9% of all spine surgeries. Though previous work has found diabetes mellitus type 2 (DM2) to increase the risk for wound infection, the influence of perioperative hyperglycemia is poorly described. OBJECTIVE To investigate perioperative hyperglycemia as an independent risk factor for surgical site infection. METHODS We retrospectively identified patients undergoing operative management of SSIs occurring after spinal surgery for degenerative pathologies. These patients were individually matched to controls based upon age, surgical invasiveness, ICD-10CM, race, and sex. Cases and controls were compared regarding medical comorbidities (including diabetes), postoperative hyperglycemia, and operative time. RESULTS Patients in the infection group were found to have a higher BMI (33.7 vs 28.8), higher prevalence of DM2 (48.5% vs 14.7%), and longer inpatient stay (8.8 vs 4.3 d). They also had higher average (136.6 vs 119.6 mg/dL) and peak glucose levels (191.9 vs 153.1 mg/dL), as well as greater variability in glucose levels (92.1 vs 58.1 mg/dL). Multivariable logistic regression identified BMI (odds ratio [OR] = 1.13), diabetes mellitus (OR = 2.12), average glucose on the first postoperative day (OR = 1.24), peak postoperative glucose (OR = 1.31), and maximal daily glucose variation (OR = 1.32) as being significant independent predictors of postoperative surgical site infection. CONCLUSION Postoperative hyperglycemia and poor postoperative glucose control are independent risk factors for surgical site infection following surgery for degenerative spine disease. These data suggest that, particularly among high-risk diabetic patients, strict perioperative glucose control may decrease the risk of SSI.

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