Analysis of the incidence and risk factors for wound XXXX in open bariatric surgery.

@entity1 @entity6 @entity9700 @entity794 @entity2737 @entity281 @entity547
BACKGROUND: Our clinical impression derived from >95% follow-up of @entity1 was that our @entity2737 rate was higher than the 1-10% reported in the literature. The purpose of this study was to determine the incidence and risk factors for @entity2737 in open bariatric surgery. METHODS: We queried our prospectively acquired bariatric surgery outcomes database, and retrospectively audited the charts of @entity1 operated from April 1 to March 31, 2003. Risk categories were obtained using the National Nosocomial Infection Surveillance (NNIS) definitions and stratification. Expected site-specific rates were adjusted for duration of operation, degree of wound contamination, and underlying disease condition. RESULTS: 269 @entity1 undergoing a standardized open Roux-en-Y gastric bypass were studied. The mean age (SD) was 39.5 (10.5) years and the mean BMI was 54.3 (9.9). Operating time averaged 63 (17) minutes, and length of stay was 4.1 (1.3) days. Based on NNIS categories 10.9 wound @entity281 were expected, but 54 were observed, for a rate of 20%. Bacterial isolates included @entity794 (39%), alpha-hemolytic strep (26%), Enterococcus (16%), @entity9700 (9%), and multiple other bacteria at 10%. Epidural analgesia and delayed antibiotic prophylaxis administration (after the incision was made) increased the odds of developing a @entity2737 , whereas gender, age, BMI, duration of surgery, and incidence of @entity6 had no effect. There was a high correlation between @entity2737 and subsequent incisional @entity547 formation. CONCLUSION: The incidence of wound @entity281 following open bariatric surgery is high, and the current recommendations for antibiotic prophylaxis are ineffective. As these @entity281 carry significant morbidity, effective methods to prevent them are needed.
