Evaluation the factors effecting surgical site infection in patients who underwent pancreatic resection

Surgical site infections are known to have an important role in postoperative mortality, morbidity and hospital stay. Identifying preoperative, perioperative and postoperative factors related or not related to patient is essential for preventing complications. This study aims to determine the risk factors effecting on sugical site infections and by to take precautions to decrease overall complications.Two hundred and ninety eight patients underwent pancreatic resection in Dokuz Eylul University School of Medicine, Department of General Surgery between March 1995 and August 2011 were included in the study. Proksimal pancreatoduodenectomy (PPD) was performed in 223 (78.2%) patients, distal pancreatectomy (DP) was performed in 49 (16.5%) patients and total pancreatectomy (TP) was performed in 16 (5.3%) patients.Age, sex, preoperative laboratory tests (total bilirubin, direct bilirubin, albumin, hemoglobin, leucocyte), ASA (American Society of Anesthesiologist) score, body mass index (BMI), preoperative hospital stay, biliary drainage procedures such as endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), biliary stent placement, preoperative antibiotherapy, operative factors (operation time, blood loss, blood transfusion) and postoperative parameters (intensive care unit stay, hospital stay, pancreatic leakage) were assessed.In this study postoperative surgical site infections (SSI) in patients with pancreatic resection and related factors in this regard were evaluated. Overall SSI rate was 20.5%, intraabdominal abscess rate was 9.7%, pneumonia rate was 8.4% and pancreatic leakage rate was found as 10.3%.Most of the factors analyzed in this study were found to be related with SSI. Particularly, pancreatic leakage was shown to be an important risk factor for SSI and intraabdominal abscess. By preventing factors causing pancreatic leakage most of the SSI can also be prevented. Patient related factors such as age, ASA score and BMI were other important risk factors.Diabetes Mellitus (DM), preoperative antibiotherapy, biliary drainage procedures, operation time, intraoperative blood loss, blood transfusion and intensive care unit stay and operative technique were found to be effective on SSI.It is known that SSI has an important role on postoperative mortality, morbidity and prolonged hospital stay. In our series patients complicated with SSI had longer hospitalization (x2) duration when compared to the hospitalization duration of non-complicated pationts.