Laura Peterson, Jean Starr
The Ohio State University Medical Center, Columbus, OH.
OBJECTIVES: Surgical site infections are a significant risk after vascular surgical procedures and can be due to a multitude of contributing factors. The purpose of this study was to examine the effect of obesity on the infection rates of vascular surgery patients undergoing groin incisions and evaluate other confounding factors.
METHODS: A single center retrospective cohort study was undertaken to examine all vascular surgery patients undergoing groin incisions for femoral artery vascular procedures from February 2007 through August 2008. Patient demographics, characteristics, including BMI, and potential confounding variables of diabetes, hypertension, smoking, renal insufficiency, coronary artery disease, cerebrovascular disease, pulmonary disease, and hyperlipidemia were recorded. All patients were monitored for infection for 30 days and those having a prosthetic implant were monitored for one year.
RESULTS: A total of 451 patients were included in this study. Six percent (n=29) of the patients developed groin wound infections diagnosed by clinical (NSQIP criteria) or microbiologic wound culture criteria. The most common causative organism was MRSA (n=9). Patients with surgical site infections had statistically higher BMIs (30 vs. 27 p=0.016). Further analysis demonstrated that the surgical site infection group had a higher percentage of obese individuals than did the infection-free group (45% vs. 26%, p=0.009). Of the other variables examined, only diabetes was associated with increased surgical site infections (p=0.007).
CONCLUSIONS: Obesity, as defined by a BMI greater than 30, and the presence of diabetes independently increase the chance of postoperative groin wound infections in the vascular surgery patient population. These patients may warrant better pre-op preparation, closer postoperative care, and modification of surgical technique in order to avoid an infectious complication.
AUTHOR DISCLOSURES: L. Peterson, Nothing to disclose; J. Starr, Nothing to disclose.
Posted April 2012