Abstract
A prospective study of 618 patients undergoing elective colorectal surgery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sepsis or faecal contamination was present, if the surgeon was a consultant and if increased risk of serious complications if the patient was male and of poor physical status. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess. Only three risk factors could be identified preoperatively: patient gender, physical status and seniority of surgeon. However, procedures low in the pelvis are more difficult and in this study group are also associated with a higher risk of wound infection. The majority of these procedures are performed by consultants. In addition, this study group has proportionally more female patients of poor physical status who are selectively being operated on by the consultant, seemingly indicating the 'consultant' as a risk factor.
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Selected References
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- Brown S. C., Abraham J. S., Walsh S., Sykes P. A. Risk factors and operative mortality in surgery for colorectal cancer. Ann R Coll Surg Engl. 1991 Sep;73(5):269–272. [PMC free article] [PubMed] [Google Scholar]
- Canivet J. L., Damas P., Desaive C., Lamy M. Operative mortality following surgery for colorectal cancer. Br J Surg. 1989 Jul;76(7):745–747. doi: 10.1002/bjs.1800760734. [DOI] [PubMed] [Google Scholar]
- Fielding L. P., Stewart-Brown S., Blesovsky L., Kearney G. Anastomotic integrity after operations for large-bowel cancer: a multicentre study. Br Med J. 1980 Aug 9;281(6237):411–414. doi: 10.1136/bmj.281.6237.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kingston R. D., Walsh S., Jeacock J. Curative resection: the major determinant of survival in patients with large bowel cancer. J R Coll Surg Edinb. 1991 Oct;36(5):298–302. [PubMed] [Google Scholar]
- Lau W. Y., Chu K. W., Poon G. P., Ho K. K. Prophylactic antibiotics in elective colorectal surgery. Br J Surg. 1988 Aug;75(8):782–785. doi: 10.1002/bjs.1800750819. [DOI] [PubMed] [Google Scholar]
- Rowe-Jones D. C., Peel A. L., Kingston R. D., Shaw J. F., Teasdale C., Cole D. S. Single dose cefotaxime plus metronidazole versus three dose cefuroxime plus metronidazole as prophylaxis against wound infection in colorectal surgery: multicentre prospective randomised study. BMJ. 1990 Jan 6;300(6716):18–22. doi: 10.1136/bmj.300.6716.18. [DOI] [PMC free article] [PubMed] [Google Scholar]