Surgical wound infection in urological patients. A four-year review

Abstract

Introduction

Surgical site infection (SSI) is a constant concern for health care professionals.

Objective

To ascertain the accumulated incidence (CI) rates of SSI, overall and by surgical procedure, at our department of urology, and to find areas for improvement.

Materials and methods

A retrospective and analytical study was conducted (January 2004/December 2007) of 91 patients. Variables examined included age, sex, mean hospital stay, diagnosis, surgical procedure, infection site, organism, and department and hospital rates. Procedures performed in more than 2 patients were analyzed. Patients with SSI caused by an infectious condition were excluded. A descriptive statistical analysis, comparison of percentages, Chi-square test were performed as appropriate.

Results

Eighty-five males and 6 females with a mean age of 64.3 ± 13.6 years were analyzed. The AI rate for the department was 1.99%, lower than for the rest of the hospital. Mean hospital stay was 22.4 ± 17.9 days. According to the CDC criteria, there were 56 superficial (61.5%), 10 deep (10.9%) and 25 organ/space (27.4%) infections. Cultures were performed in 54 infections (59.4%, lower than the hospital rate). Fifty percent of cultures were positive. Very high rates were found in cystectomy (25, 26.04%), adenomectomy (21, 16.00%) and urethroplasty (4; 10.26%), while the rates found for other procedures were lower than reported in the literature.

Conclusions

Our overall SSI rates were similar to those of other urology departments and lower than the hospital rate. SSI rates in adenomectomy were very high and a study should be conducted to find areas for improvement. SSI rates in cystectomy were also very high, in agreement with previous reports, and must also be improved, as well as the percentage of wound cultures.

Resumen

Introducción

La infección del sitio quirúrgico (ISQ) es una preocupación constante de los responsables de la asistencia sanitaria.

Objetivo

Conocer las tasas de incidencia acumulada globales y por técnicas quirúrgicas en nuestro Servicio de Urología y hallar áreas de mejora.

Material y métodos

Estudio retrospectivo y analítico (enero-2004/diciembre-2007) de 91 pacientes, que analiza variables de edad, sexo, estancia media, diagnóstico, técnica, lugar de infección, germen, tasas globales y del hospital. Se analizaron las técnicas con más de 2 casos. Fueron excluidos los pacientes con ISQ originada en un proceso infeccioso. Se realizó análisis estadístico descriptivo, comparación de porcentajes, Chicuadrado, según procediera.

Resultados

Se analizaron 85 hombres y 6 mujeres, edad media de 64,3 ± 13,6 años, tasa de incidencia acumulada para el servicio del 1,99%, inferior al resto del hospital. Estancia media de 22,4 ± 17,9 días. Según los criterios del Center for Disease Control (CDC), fueron 56 superficiales (61,5%), 10 profundas (10,9%) y 25 de órgano-espacio (27,4%). Se realizó cultivo a 54 (59,4%) (el 50% positivos), tasa inferior a la del hospital.

Hallamos tasas muy altas en cistectomía (25 [26,04%]), adenomectomía (21 [16,00%]) y uretroplastia (4; 1[0,26%]), y más bajas de lo publicado en la literatura médica en el resto de las técnicas.

Conclusiones

Nuestras tasas globales de ISQ son similares a las de otros servicios de urología y más bajas que las del propio hospital.

Las tasas en adenomectomía fueron muy altas y debería realizarse un estudio para hallar áreas de mejora. En cistectomías fueron también muy altas, en la línea de lo publicado, y también deberían mejorarse, así como el porcentaje de cultivos de herida.