Postoperative Shock as Independent Factor for Incisional Surgical Site Infection in Left-Side Colorectal Perforation

Abstract

The incidence of incisional surgical site infection (SSI) in patients with colorectal perforation is reported to be approximately 40%. Although these subcutaneous drains and wound protector are performed using a wound closure method aimed to prevent incisional SSI, the evidence for colorectal perforation is poor. Although delayed primary closure (DPC) is reported to be an effective method to maintain open wounds, its management is time-consuming and cannot be performed in all cases. Therefore, the closure method should be carefully selected based on the risk of SSI. This study aimed to evaluate the risk factors of incisional SSI in left-side colorectal perforation with stoma creation. A total of 130 patients who underwent emergency surgery for left-side colorectal perforation with stoma creation between 2007 and 2017 were retrospectively investigated. Univariable and multivariable analyses were used to identify risk factors for incisional SSI. The total number of patients with incisional SSI was 58 (45%). In the univariate analysis, postoperative shock, postoperative ventilator support, and base excess (< − 2.0) were correlated with higher risk of incisional SSI. Multivariate analysis showed that postoperative shock was an independent risk factor for incisional SSI (odds ratio, 2.60; 95% confidence interval, 1.06–6.37). Postoperative shock is the risk factor of incisional SSI in left-side colorectal perforation with stoma. DPC should be considered in case of colorectal perforation combined with shock.