Surgical Site Infection and Colorectal Surgical Procedures: A Prospective Analysis of Risk Factors

In Surgical Infections, Paulson and colleagues identify risk factors for surgical site infections in patients undergoing elective colorectal surgery. They analyzed data prospectively collected as part of a randomized, blinded trial of skin anti-sepsis, using photodocumentation, patient questionnaires, and blinded review by an attending surgeon to identify infections within 30 days of discharge. From 2011 to 2015, 787 patients undergoing colorectal surgery were analyzed, with an overall infection rate of 21.5%. Four variables--incision length, surgical indication, body mass index, and surgical approach--were significantly associated with infection. Based on these four variables, the predicted risk of infection ranges from <5% to >60%.  The authors conclude that there is a very wide range of infection risk after colorectal surgery based on both modifiable and non-modifiable factors. Identifying patients at the extreme ends of risk may help surgeons understand and mitigate contributors to infection.