Effects of Stoma and Perioperative Nutritional Status on the Incidence Surgical Site Infections in Elective Colorectal Surgery Patients

TOPIC: Surgical site infection (SSI) is one of the most frequent postoperative complications among people underwent elective colorectal surgery.  However, no studies were found which examined correlation between SSI and nutritional conditions in patients post elective colorectal surgery, with or without colostomy.  This study contributes to the SSI prevention in the colorectal surgery.

PURPOSE: This multisite prospective comparison cohort study investigated the SSI risk factors by focusing on colostomy procedure and perioperative nutritional conditions.

METHODS:  A prospective comparison cohort study was used for data collection.  The target sample was inpatients from 17 general hospitals in Japan.  The incidence of SSI and nutritional conditions were observed for 30 days following the surgery.  This study was conducted with 155 patients who underwent elective colorectal surgery (with colostomy n=72, without colostomy n=83). Significant variables derived from t-test were included as independent variables for univariate analysis. The final analysis was run with multivariate analysis with variables significant in the univariate analysis. 95% confidence intervals were also calculated.

RESULTS: The total SSI occurrence was 24 cases (15.5%).  The results showed that SSI occurred more frequently in the patients with colostomy than those without colostomy (p=0.03).  Multivariate analysis results indicated that albumin level on the postoperative and abdominal subcutaneous fats were factors which effect SSI of among patients with colostomy underwent elective colorectal surgery(p=0.03).

CONCLUSION: Providers might consider assessing patients’ perioperative nutrition status and follow up with proposed indicators.