Surgical Wound Infections after Vascular Surgery: Prospective Multicenter Observational Study

• Published in: Scandinavian journal of surgery 2010-01, Vol.99 (3), p.167-172
• Main Authors: Turtiainen, J., Saimanen, E., Partio, T., Kärkkäinen, J., Kiviniemi, V., Mäkinen, K., Hakala, T.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antibiotic Prophylaxis; Aorta, Abdominal - surgery; Aortic Diseases - economics; Aortic Diseases - surgery; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - economics; Comorbidity; Cost of Illness; Female; Finland; Graft Occlusion, Vascular - surgery; Hospital Costs; Hospitalization - economics; Humans; Ischemia - surgery; Leg - blood supply; Male; Middle Aged; Obesity - epidemiology; Prospective Studies; Risk Factors; Surgical Wound Infection - economics; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - economics
• ISSN: 1457-4969; 1799-7267
• DOI: 10.1177/145749691009900312

Background and Aims: This multicenter prospective observational study defined the incidence and risk factors of surgical wound infections (SWI) after infrarenal aortic and lower limb vascular surgery procedures and evaluated the severity and costs of these infections. Methods: The study cohort comprised of 184 consecutive patients. Postoperative complications were recorded. The additional costs attributable to SWI were calculated. Results: Eighty-four (46%) patients had critical ischaemia, 81 (45%) patients underwent infrainguinal bypass surgery and 64 (35%) received vascular prosthesis or prosthetic patch. Forty-nine (27%) patients developed SWI. Staphylococcus aureus was the leading pathogen cultured from the wound. Forty-seven of the 49 infected wounds responded to and healed with the treatment. SWI was the cause of one major amputation. Independent predictors for SWI were infrainguinal surgery (OR 7.2, 95% Cl 2.92–17.65, p < 0.001), obesity (OR 6.1, 95% Cl 2.44–15.16, p < 0.001) and arteriography injection site within the operative area (OR 2.5, 95% Cl 1.13–5.48, p = 0.02). The average cost attributable to SWI was 3320 €. Conclusion: The incidence of SWI after vascular surgery is high. The risk factors for SWI are infrainguinal surgery, obesity and arteriography injection site within the operative area. SWI increases morbidity and costs of operative treatment.