Analysis of risk factors for surgical site infection after hepatectomy

Abstract

Objective To investigate the clinical risk factors for surgical site infection (SSI) after hepatectomy. Methods Clinical data of 72 patients who underwent hepatectomy in Department of Hepato-Pancreato-Biliary, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2010 to June 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 56 males and 16 females with the age of 27 to 74 years old and the median age of 55 years old. According to whether the patients suffered SSI or not, they were divided into SSI group (n=6) and non-SSI group (n=66). Clinical parameters of patients in two groups such as primary disease, hypoproteinemia before operation, jaundice, diabetes, intraoperative blood loss, range of hepatic resection, operation duration, and time of antibiotic usage after operation were collected, and clinical risk factors for SSI were analyzed. The relationship between the incidence of SSI and clinical parameters was analyzed using Chi-square test and Fisher′s exact test. Results The incidence of SSI after hepatectomy was 8% (6/72), in which 3 patients developed intra-abdominal infection, 2 patients developed combined intra-abdominal and deep incisional infection, and 1 patient developed deep incisional infection. The primary diseases of 6 SSI patients were all biliary tract diseases. The most common pathogenic bacterium was Escherichia coli. Patients with biliary tract disease (P 48 h) (P>0.05). Conclusions Primary disease of biliary tract and hypoproteinemia before operation are risk factors for patients to develop SSI after hepatectomy. Hypoproteinemia should be remedied as far as possible before hepatectomy. Use of antibiotics can prevent SSI in patients undergoing hepatectomy. It is safe to cease antibiotics within 48 h after hepatoectmy. Key words: Hepatoectmy; Surgical site infection; Biliary tract diseases; Hypoproteinemia; Cephalo-sporins