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Risk factors for surgical site infection in pediatric surgery

Written by Malashenko A.A., Aslanov B.I., Nabieva A.S., Yebert M.A., Kolosovckaya E.N.

  UDK: 617–089–022–085.28–053.2 | Pages: 61–63 | Full text PDF | Open PDF 

Annotation:

Objective. Information on risk factors for the development of surgical site infections (SSI) is the basis of preventive measures. However, the currently known risk factors are well studied mainly in populations of adult patients, while there is very little data on the predictors of SSI in pediatric surgery. In particular, there is insufficient data on “external” factors, associated with surgical intervention, and “internal” factors, associated with the patient›s condition, their correlation and significance in the development of SSI in pediatric surgery.
Methods. The study was conducted in the Pediatric City Hospital No. 19. Three surgical departments were involved in the study: traumatology, surgical department and neurosurgery. The subject of the study were patients and medical records. The significance of “external” and “internal” risk factors for SSI was assessed during the study. 1246 patients from pediatric surgery departments participated in the study in the period from 2015–2017. SSI was detected using standard case definitions. For a number of risk factors with dichotomous characteristics a case-control study was conducted.
Results. A significantly higher incidence of SSI was observed in a group of patients who had the wound class of 3 or more. When assessing the likelihood of development of SSI depending on the integral index of NNIS, it was revealed that the highest risk was observed with the NNIS index of 3 – 71.4 per 100 operations. The incidence of infection increased proportionally with the index: NNIS 0 – 3.0, NNIS 1 – 33.4, NNIS 2 – 28.6 per 100 surgical interventions. The odds ratio (ОШ) with confidence intervals for the urgency of the operation was 6.7, for drainage – 1.6, for the duration of surgery – 2.2. Such factors as the type of anesthesia, shaving, blood transfusion and the number of operations performed simultaneously were not significant in the development of SSI in the pediatric patient population. Evaluating the effect of “internal” risk factors for SSI has shown that among all the predictors studied only co-morbidities significantly increased the risk of SSI in children. Other risk factors for SSI that are significant in the adult population of surgical patients (age, obesity, length of hospital stay) did not contribute to an increase in the likelihood of SSI in pediatric surgery.
Conclusions. It was revealed that the “external” factors associated with surgical interventions predominate in the structure of risk factors of SSI in pediatric surgery: type of operation, class of the surgical wound, urgency of the operation, drainage, duration of the operation. Among the “internal” factors associated with the patient›s condition only the presence of concomitant diseases is important.

Links to authors:

A.A. Malashenko1, 2, B.I. Aslanov1, A.S. Nabieva3, M.A. Yebert4, E.N. Kolosovckaya1
1 North-Western State Medical University named after I.I. Mechnikov (45 Piskarevsky Ave. Saint-Petersburg 195067 Russian Federation),
2 Rauhfus Children›s City Hospital No. 19 (8 Ligovsky Ave. Saint-Petersburg 191014 Russian Federation),
3 St. Petersburg Pediatric Medical University (2 Litovskaya St. Saint-Petersburg 194100 Russian Federation),
4 Military Medical Academy named after S.M. Kirov (6 Akademika Lebedeva St. Saint-Petersburg 194044 Russian Federation)


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