Archives of Plastic Surgery

  • 제40권5호
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  • Pages.522-529
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  • 2013
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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The Relationship between Preoperative Wound Classification and Postoperative Infection: A Multi-Institutional Analysis of 15,289 Patients

  • Mioton, Lauren M. (Department of Plastic Surgery, Vanderbilt School of Medicine) ;
  • Jordan, Sumanas W. (Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine) ;
  • Hanwright, Philip J. (Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine) ;
  • Bilimoria, Karl Y. (Department of Surgery, Northwestern University, Feinberg School of Medicine) ;
  • Kim, John Y.S. (Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine)
  • 투고 : 2013.01.08
  • 심사 : 2013.05.07
  • 발행 : 2013.09.15
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Background Despite advances in surgical techniques, sterile protocols, and perioperative antibiotic regimens, surgical site infections (SSIs) remain a significant problem. We investigated the relationship between wound classification (i.e., clean, clean/contaminated, contaminated, dirty) and SSI rates in plastic surgery. Methods We performed a retrospective review of a multi-institutional, surgical outcomes database for all patients undergoing plastic surgery procedures from 2006-2010. Patient demographics, wound classification, and 30-day outcomes were recorded and analyzed by multivariate logistic regression. Results A total of 15,289 plastic surgery cases were analyzed. The overall SSI rate was 3.00%, with superficial SSIs occurring at comparable rates across wound classes. There were similar rates of deep SSIs in the clean and clean/contaminated groups (0.64%), while rates reached over 2% in contaminated and dirty cases. Organ/space SSIs occurred in less than 1% of each wound classification. Contaminated and dirty cases were at an increased risk for deep SSIs (odds ratios, 2.81 and 2.74, respectively); however, wound classification did not appear to be a significant predictor of superficial or organ/space SSIs. Clean/contaminated, contaminated, and dirty cases were at increased risk for a postoperative complication, and contaminated and dirty cases also had higher odds of reoperation and 30-day mortality. Conclusions Analyzing a multi-center database, we found that wound classification was a significant predictor of overall complications, reoperation, and mortality, but not an adequate predictor of surgical site infections. When comparing infections for a given wound classification, plastic surgery had lower overall rates than the surgical population at large.

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참고문헌

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