Introduction/Background Approximately 10% of all malignancies in women originate from the internal genitalia. Surgery is the main therapeutic approach. These procedures tend to be extensive multivisceral interventions and are associated with up to 15% wound infection rates (O’Donnell et al, 2019). The aim of the study was to determine perioperative risk factors for surgical site infections (SSI). A potential relationship between the perioperative antibiotic prophylaxis, the occurring pathogen spectrum, the antibiotic treatment versus surgical revision and the oncological outcome was investigated to identify risk factors and to improve the outcome by optimizing these factors.

Methodology In a monocentric study, a retrospective explorative analysis of epidemiological, clinical histopathological and microbiological data was performed. 700 women over the age of 18 with malignancies of the internal genitalia who underwent surgical treatment were included. Follow-up time was 30 days after surgery.

Results Within the patient population and according to the CDC-classification, 10.1% (71/702) SSIs and 3.3% (23/702) cases of a superficial wound dehiscence were diagnosed. In total 86.6% (608/702) underwent a laparotomy and 13.4% (94/702) a laparoscopy. There was a significant association between obesity (p<0.001), staples versus sutures (p=0.019) and laparotomy (p=0.017) and an increased risk for SSIs. The main pathogens detected were Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa. Therapeutically, the wound infections were mainly treated by surgical revision (47.9%, 34/71) and pure antibiotic administration (36.6%, 26/71).

Conclusion An increased body mass index (BMI), staples for wound closure and a laparotomy are associated with an increased risk of SSIs. The pathogen spectrum is dominated by enterobacteriales. Decreasing SSIs is important in order to optimize the outcome of adjuvant therapy and minimize the rehospitalisation rates.