Post-discharge surgical site infections after uncomplicated elective colorectal surgery: impact and risk factors. The experience of the VINCat Program

A Prognostic Model of Surgical Site Infection Using Daily Clinical Wound Assessment

“…(35–38) Delayed diagnosis of post-discharge SSIs has significant financial and quality costs, with more than half of patients who develop them readmitted to the hospital. (26, 37) Our dataset is unique in that, coming from a hospital in the Netherlands, length of stay is significantly longer than in the US (median 12 days in our dataset vs 5-6 days in the US), allowing us to observe events that might occur after discharge in the US. (3, 39) Yet, our dataset also has inherent limitations which likely decreased our model's ultimate performance—e.g., due to lack of data on patients after discharge, we combined patients with post-discharge SSI with patients who never developed SSI, and due to low numbers of deep and organ-space SSI, we combined all types of SSI into a single endpoint; with both of these decisions, we took a conservative, intention-to-treat approach rather than selectively excluding populations who do not fit neatly—to better show the prospective, “real-world” performance of our model.…”

“…(12–15, 25, 26) Our initial analyses showed that baseline and serial features generally did not vary significantly among different classes of SSI, and we could not separately model subtypes of SSI due to the small numbers of deep and organ-space infections. In addition, though a patient may have developed multiple types of SSI during their hospital stay, we only include their first infection in this analysis.…”

Postoperative hyperglycemia and adverse outcomes in patients undergoing colorectal surgery: results from the Michigan surgical quality collaborative database

“…However, there are no randomized clinical trials examining these recommended ranges in cases undergoing elective surgical procedures. Specifically, for the colorectal surgery population, there are very few retrospective studies investigating postoperative hyperglycemia [1,9,10]. Kwon and colleagues analyzed data from the Surgical Clinical Outcomes Assessment Program and found that patients, both diabetic and non-diabetic, with hyperglycemia on postoperative day 1 or 2 were at increased risk for infection, re-operative interventions, and death [9].…”

Chlorhexidine With Isopropyl Alcohol Versus Iodine Povacrylex With Isopropyl Alcohol and Alcohol- Versus Nonalcohol-Based Skin Preparations

“…21 the true impact of postoperative wound complications on patients and their families is difficult to quantify, and the burden of both disability and resultant lost income is significant. 6,22 in those patients who develop postoperative superficial or deep ssis during their index hospitalization, a higher rate of 30-day readmission has been observed. 21 lawson et al 21 noted an overall incidence of ssi of 11% in their review of patients undergoing elective colectomy, with a readmission rate among those patients of 31%.…”