Surgical site infections in women and their association with clinical conditions

de Araújo Madeira, Maria Zélia; Trabasso, Plínio

doi:10.1590/0037-8682-0125-2014

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Major Articles • Rev. Soc. Bras. Med. Trop. 47 (4) • Jul-Aug 2014 • https://doi.org/10.1590/0037-8682-0125-2014 linkcopy

Surgical site infections in women and their association with clinical conditions

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction Surgical site infections (SSIs) can affect body tissues, cavities, or organs manipulated in surgery and constitute 14% to 16% of all infections. This study aimed to determine the incidence of SSIs in women following their discharge from a gynecology outpatient clinic, to survey different types of SSIs among women, and to verify the association of SSIs with comorbidities and clinical conditions.

Methods Data were collected via analytical observation with a cross-sectional design, and the study was conducted in 1,026 women who underwent gynecological surgery in a teaching hospital in the municipality of Teresina, in the northeast Brazilian State of Piauí, from June 2011 to March 2013.

Results The incidence of SSIs after discharge was 5.8% among the women in the outpatient clinic. The most prevalent surgery among the patients was hysterectomy, while the most prevalent type of SSI was superficial incisional. Comorbidities in women with SSIs included cancer, diabetes mellitus, and hypertension.

Conclusions Surveillance of SSIs during the post-discharge period is critical for infection prevention and control. It is worth reflecting on the planning of surgical procedures for patients who have risk factors for the development of SSIs.

Surgical wound infection; Epidemiological surveillance; Hospital discharge; Gynecological surgical procedures

	Number	Percentage
Length of hospital stay (days)
2	2	3.3
3	49	81.7
≥ 4	9	15.0
Surgery type
abdominal hysterectomy	43	71.7
colpoperineoplasty	1	1.7
vaginal hysterectomy	1	1.7
exploratory laparotomy	3	5.0
leiomyomectomy	2	3.3
oophorectomy	9	15.0
salpingoplasty	1	1.7

Surgery performed	Type of SSI				Total
	SSI1		SSI2		Total
	n	%	n	%	n	%
Colpoperineoplasty	1	100.0	0	0.0	1	100.0
Hysterectomy	30	69.8	13	30.2	43	100.0
Vaginal hysterectomy	1	100.0	0	0.0	1	100.0
Laparotomy	2	66.7	1	33.3	3	100.0
Myomectomy	2	100.0	0	0.0	2	100.0
Oophorectomy	7	77.8	2	22.2	9	100.0
Salpingectomy	1	100.0	0	0.0	1	100.0
Total	44	73.3	16	26.7	60	100.0

Microorganisms	Cultures
Microorganisms	n	%
Staphylococcus aureus	12	66.7
Staphylococcus coagulase-negative	2	11.1
Pseudomonas aeruginosa	3	16.7
Acinetobacter baumannii	1	5.5

Variables	OR_crude	95% CI	OR_adjusted	95% CI
Age*			1.025	1.002-1.048
Post-operative time (days)*			0.853	0.789-0.923
Income
no income	0.235	0.067-0.832	0.299	0.071-1.263
1 MW	0.625	0.218-1.872	0.692	0.192-2.495
2 MW	0.240	0.069-0.828	0.442	0.106-1.834
≥ 3 MW	1		1
Nutritional classification
low weight	2.417	1.008-5.794	2.316	0.849-6.319
eutrophic	1.187	0.660-2.134	1.270	0.660-2.442
overweight/obese	1		1
Cancer
yes	7.850	3.560-17.308	8.329	3.217-21.564
no	1		1
Chronic vascular disease
yes	4.076	0.449-37.047	1.635	0.154-17.375
no	1		1
Diabetes mellitus
yes	5.041	2.698-9.418	3.371	1,610-7.061
no	1		1
Hypertension
yes	3.074	1.757-5.377	2.082	1.064-4.075
no	1		1
Smoking
yes	3.316	1.412-7.789	3.506	1.284-9.574
no	1		1

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[TFN01t02] SSI: surgical site infections; SSI1: superficial incisional; SSI2: deep incisional.