Article Text
Abstract
Introduction/Background Surgical site infection (SSI) complicates 12% of all surgical procedures in the Egypt. Gynecological cancers compromise a large percent all cancers affecting women in the Egypt. Surgery remains the mainstay of treatment despite an increase in the use of minimally invasive techniques.
Methodology A retrospective analysis of women undergoing laparotomy for gynecological malignancy was undertaken at El-Shatby Hospital gyn-oncology Centre a 6-month period July-December 2023. All patients were categorized using the derived patient status risk index described by the American Society of Anesthesiologists (ASA). Surgeries were categorized into three groups of increasing complexity based on the overall score (low: score ≤3; intermediate: score 4–8; radical: ≥8). In addition, the duration of surgery and estimated blood loss were recorded. The Centers for Disease Control and Prevention (CDC) definitions for superficial incisional, deep incisional and organ/space SSI were used to standardize diagnosis.
Results In total, 125 women underwent laparotomy for gynecological cancer during this period. A clinical diagnosis of SSI was made in 10 (8%) women. Body mass index (BMI) was the strongest risk factor for SSI and the following factor was Diabetes Mellitus. Wound drains were also associated with increased risk of SSI. The median age was 42 years with a median BMI of 28.0kg/m2. Preoperative performance status varied with 6 (60%) patients classified as ASA 1, 2 (20%) as ASA 2, and 2 (20%) as ASA 3. 50% of patients were hypoalbuminemia. The majority of incisions were midline and extended above the level of the umbilicus to the pubis. Median operating time was 150 min.
Conclusion This analysis demonstrates the need to determine whether addressing modifiable risk factors can prevent SSI in surgery. Ultimately, a reduction in delayed discharge and subsequent delays in the commencement of adjuvant treatment could result in better outcomes.
Disclosures The authors declare no conflict of interest.
This research received no external funding.