Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation

O’Donnell, Rachel; Beirne, James; Biliatis, Ioannis; Bolton, Helen; Bradbury, Melissa; Craig, Elaine; Gajjar, Ketan; MacKintosh, Michelle L.; MacNab, W.; Madhuri, Thumuluru Kavitha; McComiskey, Mark; Myriokefalitaki, Eva; Newton, Claire; Ratnavelu, Nithya; Taylor, Siân; Thangavelu, Amudha; Rhodes, Sarah; Crosbie, Emma J.; Edmondson, Richard J.; Wan, Y. Louise

doi:10.1136/bmjopen-2018-024853

Cited by 20 publications

(19 citation statements)

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“…The majority of infection-associated costs arise from prolonged hospitalization, with additional expenditure attributable to medical staff and treatment. As the demand for surgical procedures rises, the incidence and associated costs of SSI will likely escalate [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis

Getaneh

Negesse

Dessie

2020

BMC Pregnancy Childbirth

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Background: Surgical site infection (SSI) affects nearly one third of patients who have undergone a surgical procedure. It is a significant and substantial cause of surgical patient morbidity and mortality later with human and financial costs threat. There are fragmented and pocket studies which reported the prevalence of SSI among mothers who experienced for cesarean section and its risk factors. However, there is no any solid evidence established at the national level; which was also the interest of the authors to fill this gap. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of SSI after cesarean section and its associated factors at national level. Methods: Original articles were searched in PubMed, MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal, and Cochrane Library. All observational studies defined outcome of variable "SSI as infection related to an operation procedure that occur at or near surgical incision within 30 days of operation or after one year if an implant is placed" were considered. Data were extracted using standard data extraction excel spread sheet checklists developed according to 2014 Joanna Briggs Institute Reviewers' Manual after the quality was assessed through Newcastle-Ottawa quality assessment scale. The I 2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger's tests were used to check for publication bias. A fixed effect model was used to estimate the pooled prevalence of SSI. Odds Ratio (OR) with 95% Confidence Interval (CI) was also considered to determine the association of identified variables with SSI. Statistical analysis was conducted using STATA version 14 software. Result: From initial 179 identified articles, 11 were eligible for inclusion in the final systematic review and metaanalysis. Studies with a score of 6 and above were included for final analysis. All included studies were institutional based cross sectional. The pooled estimate of SSI after cesarean section in Ethiopia was 9.72% (95%CI: 8.38, 11.05).

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Section: Introductionmentioning

confidence: 99%

Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis

Getaneh

Negesse

Dessie

2020

BMC Pregnancy Childbirth

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“…Published research papers revealed some risk factors for some special sites of HAIs such as surgical site infection (SSI), urinary tract infections, HAIs occured frequently in neurological ICU, etc. [8–11]. But there were few research focused on risk factors of HAIs in elderly.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of health care–associated infection in elderly patients: a retrospective cohort study performed at a tertiary hospital in China

Zhao

Wang

et al. 2019

BMC Geriatr

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Background The elderly inpatients are in high risk of suffering health-care associated infection (HAI). The study aimed to analyze the risk factors of health-care associated infection (HAI) in elderly hospitalized patients to prevent it and improve the recovery rate of elderly patients. Methods The study was a Retrospective Cohort Study based on a 3-year surveillance in elderly inpatients in a large tertiary hospital in China. A retrospective review of the elderly inpatients ≥60 years with or without HAI were conducted. Binary multivariable logistic regression was used to evaluate the potential association between HAI and risk factors. Results We investigated a total of 60,332 subjects aged 60 years old or above. The incidence of HAI in elderly was 2.62%. With adjustment for some factors, advanced age, hospital days before HAI, intensive care unit (ICU) admission, use of ventilator, central line catheter or urinary catheter and cerebral hemorrhage, cerebral infarction, brain neoplasms, diabetes mellitus, coronary artery disease, malignant tumor and malignant hematonosis had significantly increased odds ratios (OR) of suffering from HAI compared with the control group but body weight and operation decreased OR. Conclusion Our findings suggested that advanced age, accompanied by some neurological and chronic noncommunicable diseases, hospital days before HAI, ICU admission, and use of devices were risk factors of suffering HAI in the elderly but the body weight and operation were the potential protective factors in this sample.

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“…Our study provides evidence that wound complications affect the time of initiating adjuvant treatments and hospitalization in patients with ovarian cancer, which may affect responses to chemotherapy and overall survival in these patients. [5][6][7] However, there were no differences in progression free survival or overall survival between patients with wound complications and those with clear healing, which may be because of the small number of patients with wound complications or the short follow-up period. Therefore, additional data are needed to assess the effect of these delays on cancer survival.…”

Section: Discussionmentioning

confidence: 91%

“…3 4 In ovarian cancer specifically, wound complications have been shown to be associated with increased readmission rates and postoperative mortality, and delays in chemotherapeutic treatment after abdominal surgery. [5][6][7] Subcutaneous wound drains were developed approximately two decades ago to drain transudate from wounds. 8 These drains reduce potential deadspace in the subcutaneous tissue by preventing the accumulation of transudate from surgical wounds.…”

Section: Introductionmentioning

confidence: 99%

Impact of subcutaneous negative pressure drains on surgical wound healing in ovarian cancer

Chung

Lee

Nam

et al. 2020

Int J Gynecol Cancer

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IntroductionSubcutaneous negative pressure wound drains have been used to reduce wound complication rates in various surgical procedures. However, research on the benefits of subcutaneous drains on wound healing after ovarian cancer surgery is limited. The aim of this study was to assess the effects of subcutaneous negative pressure drains on wound healing after abdominal surgery for ovarian cancer.MethodsPatients who underwent surgery with a midline incision for ovarian cancer between February 2015 and May 2019 were retrospectively examined. Patients were divided into two groups according to the presence (group 1; n=99) or absence (group 2; n=213) of subcutaneous wound drains. The primary endpoint was the incidence of wound complications within 8 weeks after abdominal surgery. The secondary endpoints were time interval from surgery to adjuvant chemotherapy and survival.ResultsPatients in group 1 were older (mean 58.5 vs 55.4 years; p=0.02), and had higher rates of previous abdominal surgery (66.7% vs 47.9%; p=0.002), bowel surgery (47.5% vs 34.3%; p=0.026), and had a high surgical complexity score (53.5% vs 33.8%; p<0.001) compared with patients in group 2. Median body mass index was not different between the two groups: group 1, 22.9 kg/m2 (range 16.0 to 33.3) and group 2, 22.8 kg/m2 (range 16.4 to 37.5) (p=0.858). A higher rate of clear wound healing (82.8% vs 71.8%; p=0.036) and a lower rate of seroma formation (6.1% vs 16.0%; p=0.015) were observed in group 1 compared with group 2. After multivariate analysis, subcutaneous wound drain placement was identified as an independent predictive factor for preventing wound complications (adjusted odds ratio 0.43; 95% confidence interval 0.21 to 0.87). Time interval from surgery to adjuvant treatment was significantly longer in patients with wound complications than in those with clear wound healing (mean 23.6 vs 19.2 days; p=0.003). Kaplan–Meier analysis, however, showed no significant differences in progression free or overall survival between the two groups (p=0.35 and p=0.96, respectively).ConclusionThe prophylactic use of subcutaneous negative pressure drains after abdominal surgery for ovarian cancer significantly reduced the incidence of wound complications in this study.

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Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation

Cited by 20 publications

References 20 publications

Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis

Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis

Risk factors of health care–associated infection in elderly patients: a retrospective cohort study performed at a tertiary hospital in China

Impact of subcutaneous negative pressure drains on surgical wound healing in ovarian cancer

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