Postoperative infection in eventrorrhaphy: Related factors

Infección postoperatoria en eventrorrafias: Factores relacionados

Introduction: incisional or ventral hernias develop in 1 to 16% of patients after laparotomy. Consequently, the performance of incisional herniorrhaphies has become very frequent in surgery services. The National Nosocomial Infection Surveillance System NNISS, reports surgical site infection (SSI) as the third most frequent nosocomial infection among hospitalized patients, with a prevalence rate of 14 to 16%.' Multiple factors influence the development of SSIs following an incisional herniorrhaphy and SSI is identified as a recurrence risk factor. Objective: to describe the frequency of SSIs, and identify related factors for SSI, in patients who underwent an incisional herniorrhaphy. Methodology: a descriptive cross-sectional study conducted between July 1, 2004 and July 1, 2006 in the San José Hospital analyzed demographic, surgical, incisional-hernia-specific and postoperative-specific variables, as well as infection-risk scales. Results: of the 132 patients studied, 58.3% (77) were females and 41.6% (55) males; the mean age was 50 years. The overall frequency of SSIs was 9% (12); superficial wound SSI was identified in 10 cases (7.5%) and deep wound SSI in 2 cases (1.5%). Antecedents of patients with SSI included diabetes mellitus 25%, coronary artery disease and COPD in 8.3% and 33% had a history of cigarette smoking. In patients without SSI the latter were 5%, 2.5%, 5.8% and 9% respectively. The mean time of surgery procedure was 115 minutes in patients with SSI and 86 minutes in patients without SSI. Four patients (33 %) with SSI required an emergency surgery procedure due to incarceration. No SSI was documented in two patients who required intestinal resection. NNISS and SENIC scores for the risk of infection in these two patients were 3 and 4 respectively. Conclusions: the overall frequency of SSIs and risk factors described in this study are similar to those reported in published medical literature. Further prospective studies with adequate follow-up are required to identify risk factors for SSIs. Monitoring of the behavior of SSIs secondary to incisional herniorrhaphy must also be conducted in the hospital setting. Abbreviations: ISO, infection of the operative site; COPD, chronic obstructive pulmonary disease; NNISS, national nosocomial infection surveillonce systems; IPO, postoperative infection.

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