Monitoring of postoperative surgical site infections in 1005 colorectal surgery patients in a grade Ⅲ (A) hospital, Shandong, 2021−2022

Objective To conduct targeted monitoring of colorectal surgery patients in a grade Ⅲ (A) hospital, understand the incidence of postoperative surgical site infection (SSI) and potential risk factors, and its impact on postoperative hospitalization days.

Methods According to the requirements of the Standard for Nosocomial Infection Surveillance (WS/T 312－2009), all colorectal surgery patients admitted to the gastrointestinal surgery department of the hospital from 2021 to 2022 were subjected to targeted monitoring of SSI and post discharge follow-up. The analysis used 14 indicators, including gender, age, surgical site, American Society of Anesthesiologists score, surgical duration score, incision cleanliness, National Nosocomial Infections Surveillance (NNIS) score, postoperative hospitalization days and others. R4.2.2 software was used for statistical analysis, and risk factor analysis was conducted using univariate logistic regression and multivariate logistic stepwise regression models.

Results A total of 1005 colorectal surgery patients were included, in whom 95 had SSI (9.45%, 95%CI: 7.80%–11.42%), including 47 superficial incisional infections, 10 deep incisional infections, and 38 organ/space infections; In these cases, and 50 were found through follow-up after discharge, accounting for 52.63%. Long duration of surgery (OR=1.95, 95%CI: 1.25–3.06, P=0.003) and contamination of incision (OR=2.68, 95%CI: 1.16–6.19, P=0.021) were the independent risk factors of postoperative colorectal infections. Patients with a higher NNIS risk index (2–3) were more likely to develop SSI (OR=3.05, 95%CI: 1.59–5.85). The postoperative hospitalization days were significantly longer in patients with organ/space infections than in those without SSI (14 days vs. 5 days, P<0.001).

Conclusion Targeted monitoring of SSI and follow-up after discharge are necessary to understand the incidence of SSI, and colorectal surgery has a higher risk for SSI. Shortening the duration of surgery and reducing the contamination of surgical incision can effectively reduce the incidence of SSI, and the incidence of organ/space infection can significantly increase the postoperative hospitalization days.