Pre-operative and early post-operative factors associated with surgical site infection after laparoscopic sleeve gastrectomy.

Abstract

BACKGROUND:

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.

PATIENTS AND METHODS:

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.

RESULTS:

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 BMI >45 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 concentration <5.3 g/dL (OR 13; p=0.003), a plasma cortisol >30 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 glucose >128 mg/dL (OR 4.7; p=0.012) and hemoglobin <11g/dL (OR 7.5; p=0.002) were associated with SSI.

CONCLUSIONS:

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.

• Authors: Jaime Ruiz-Tovar, Inmaculada Oller, Carolina Llavero, Antonio Arroyo, Jose Luis Muñoz, Alicia Calero, María Diez, Lorea Zubiaga, Rafael Calpena
• Journal: Surgical infections (Surg Infect (Larchmt)) Vol. 14 Issue 4 Pg. 369-73 (Aug 2013) ISSN: 1557-8674 [Electronic] United States
• PMID: 23718274 (Publication Type: Journal Article)

Topics

• Adult
• Body Mass Index
• Female
• Gastrectomy (adverse effects)
• Humans
• Laparoscopy (adverse effects)
• Male
• Middle Aged
• Obesity, Morbid (surgery)
• Perioperative Period
• Prospective Studies
• Risk Factors
• Statistics, Nonparametric
• Surgical Wound Infection (etiology)