1. Pre-Operative and Early Post-Operative Factors Associated with Surgical Site Infection after Laparoscopic Sleeve Gastrectomy
- Author
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Alicia Calero, Jaime Ruiz-Tovar, Inmaculada Oller, Antonio Arroyo, María Diez, Jose Luis Muñoz, Carolina Llavero, Lorea Zubiaga, and Rafael Calpena
- Subjects
Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Statistics, Nonparametric ,Body Mass Index ,Gastrectomy ,Risk Factors ,medicine ,Humans ,Surgical Wound Infection ,Prospective Studies ,Post operative ,Perioperative Period ,Prospective cohort study ,Abscess ,Laparoscopic sleeve gastrectomy ,business.industry ,General surgery ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Pre operative ,Obesity, Morbid ,Surgery ,Infectious Diseases ,Female ,Laparoscopy ,business ,Body mass index ,Surgical site infection - Abstract
Surgical procedures on obese patients are expected to have a high incidence of surgical site infection (SSI). The identification of pre-operative or early post-operative risk factors for SSI may help the surgeon to identify subjects in risk and adequately optimize their status. We conducted a study of the association of comorbidities and pre- and post-operative analytical variables with SSI following laparoscopic sleeve gastrectomy for the treatment of morbid obesity.We performed a prospective study of all morbidly obese patients undergoing laparoscopic sleeve gastrectomy as a bariatric procedure between 2007 and 2011. An association of clinical and analytical variables with SSI was investigated.The study included 40 patients with a mean pre-operative body mass index (BMI) of 51.2±7.9 kg/m(2). Surgical site infections appeared in three patients (7.5%), of whom two had an intra-abdominal abscess located in the left hypochondrium and the third had a superficial incisional SSI. Pre-operatively, a BMI45 kg/m(2) (OR 8.7; p=0.008), restrictive disorders identified by pulmonary function tests (OR 10.0; p=0.012), a serum total protein concentration5.3 g/dL (OR 13; p=0.003), a plasma cortisol30 mcg/dL (OR 13.0; p=0.003), and a mean corpuscular volume (MCV)82 fL (OR 1.6; p=0.04) were associated with post-operative SSI. Post-operatively, a serum glucose128 mg/dL (OR 4.7; p=0.012) and hemoglobin11g/dL (OR 7.5; p=0.002) were associated with SSI.The study supports the role of restrictive lung disorders and the values specified above for preoperative BMI, serum total protein and cortisol concentrations, and MCV, and of post-operative anemia and hyperglycemia as risk factors for SSI. In these situations, the surgeon must be aware of and seek to control these risk factors.
- Published
- 2013