Surveillance and risk factors on hysterectomy wound infection rate in Gran Canaria, Spain

Molina‐Cabrillana, Jesús; Valle-Morales, Leonor; Hernández-Vera, J.R.; López-Carrió, I.; García-Hernández, José Ángel; Bolaños-Rivero, Margarita

doi:10.1016/j.ejogrb.2006.11.005

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…Obesity has been found to be a risk factor for SSI by many investigators, in particular after abdominal and gynecologic operations. 24 Obesity has also been shown to be independently associated with SSI after hysterectomy (vaginal or abdominal) 17 and specifically after abdominal hysterectomy. 6,7 In our current study receiving a blood transfusion was associated with significantly increased odds of incisional SSI.…”

Section: Discussionmentioning

confidence: 99%

“…Before routine use of prophylactic antibiotic regimens, SSI rates reported for abdominal hysterectomy were 9% or higher in all 4-8 but one publication. 9 During the last decade, reported SSI rates after abdominal hysterectomy have ranged from 1.7 to 11%, 10-17 while SSI rates reported in individual studies after vaginal hysterectomy (i.e., vaginal cuff cellulitis) ranged from 3.1 to 4.8%. 12,15,17 Thus there appears to be a wider range of SSI rates reported from individual institutions after abdominal hysterectomy than after vaginal hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors for SSI identified by multivariable analysis in previous studies include obesity, 7,17 lower serum albumin, 14 depth of subcutaneous tissue, 6 abdominal approach, 4,17 open vaginal cuff, 7 younger age, 4 non-private patient status, 4 and inadequate antimicrobial prophylaxis, 4,7,14,17 although only 3 used standard criteria to define SSI. 6,14,17 It is essential to identify independent risk factors in order to create a risk index specific to abdominal hysterectomy. The National Nosocomial Infection Surveillance (NNIS) risk index, most commonly used by hospital epidemiologists, performs better as a risk stratification method between different types of operations rather than within an individual type of operation.…”

Section: Introductionmentioning

confidence: 99%

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Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

Olsen

Higham-Kessler

Yokoe

et al. 2009

Infect. Control Hosp. Epidemiol.

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Objective The incidence of surgical site infection (SSI) ranges widely from 2-21% after hysterectomy. There is insufficient understanding of risk factors to build a specific risk stratification index. Methods Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from 7/1/03 - 6/30/05 at four institutions. SSIs were defined using CDC/NNIS criteria. Independent risk factors for abdominal hysterectomy were identified by logistic regression. Results There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSI after abdominal and 14 organ-space SSI after vaginal hysterectomy. Because risk factors for organ-space SSI were different in univariate analysis, further analyses focused on incisional SSI after abdominal hysterectomy. The maximum serum glucose within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI and lowest in uninfected patients (median 189, 156, and 141mg/dL, p = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio (OR) 2.4) and morbid obesity (body mass index (BMI) > 35, OR 5.7). Duration of operation > 75th percentile (OR 1.7), obesity (BMI 30-35, OR 3.0), and lack of private health insurance (OR 1.7) were marginally associated with increased odds of SSI. Conclusions Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer operative time and lack of private health insurance were marginally associated with SSI. A specific risk stratification index could help to more accurately predict the risk of incisional SSI following abdominal hysterectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

Olsen

Higham-Kessler

Yokoe

et al. 2009

Infect. Control Hosp. Epidemiol.

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“…This was decided because we primarily sought to include patients with a high risk of surgical site infections, thus avoiding low power to detect or reject an intervention effect. The frequency of surgical site infection is estimated to be only 2% in patients with American Society of Anesthesiologists physical status score I-II undergoing clean or clean-contaminated abdominal hysterectomy with a duration of surgery less than 2 hours [ 1 ] and 4% after abdominal hysterectomy for benign conditions [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Perioperative oxygen fraction – effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial

Meyhoff

Wetterslev

Jørgensen

et al. 2008

Trials

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Background: A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (FiO 2 = 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving FiO 2 = 0.80. It has not been settled if a high inspiratory oxygen fraction increases the risk of pulmonary complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery.

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“…The VCUF -infections were classified as superficial incisional SSI as per CDC/NHSN criteria [13]. In literature [14][15][16][17][18][19], while VCUF -infection ranged from 3.1 to 4.8%. [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Vaginal Cuff Infection After Hysterectomy in Ukraine

Salmanov

Vitiuk

Hrynchuk³

et al. 2021

Wiad Lek

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The aim: To obtain the first estimates of the current prevalence of vaginal cuff infection after hysterectomy and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of women who had an abdominal, vaginal or laparoscopic hysterectomy from 2017 to 2019 in 7 women hospitals of Ukraine. Definitions of vaginal cuff infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network, USA. Results: Total 12.6% women’s after hysterectomy had vaginal cuff infections. Of these cases, 20.3% after abdominal, 15.5% vaginal and 4.1% laparoscopic hysterectomy were identified. The predominant pathogens of VCUF infections were: Escherichia coli (18.6%), Enterobacter spp. (12.4%), Staphylococcus aureus (10.8%), Streptococcus spp. (9,7%), Klebsiella pneumoniae (8.2%), Pseudomonas aeruginosa (7.6%), Enterococcus faecalis (7,0%) and Proteus spp. (7.0%). Methicillin-resistance was observed in 12.9% of S. aureus (MRSA) and 9.7% CoNS. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to thirdgeneration cephalosporins was observed in 8.9% K. pneumoniae and E.coli 11.9% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 22.7%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (32.6%, vs 12.3%). Conclusions: Vaginal cuff infections in women after hysterectomy are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. The incidence of VCUF infections after hysterectomy differs depending on the type of surgical procedure.

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Surveillance and risk factors on hysterectomy wound infection rate in Gran Canaria, Spain

Cited by 9 publications

References 21 publications

Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

Perioperative oxygen fraction – effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial

Vaginal Cuff Infection After Hysterectomy in Ukraine

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