Nwachukwu, Ijeoma and Visa, Arjun and Holbrook, Charlotte and Tan, Yew-Wei (2024) Identifying Risk Factors for Surgical Site Infection After Stoma Closure in Infants for Targeted Implementation of Surgical Site Infection Reduction Bundle. Surgical Infections, 25 (3). pp. 185-191. ISSN 1096-2964, DOI https://doi.org/10.1089/sur.2023.248.
Full text not available from this repository.Abstract
Background: To determine risk factors for surgical site infection (SSI) in infants after stoma closure, to identify at-risk patients, plan timing of surgery, and implement SSI-reduction strategies.Patients and Methods: A single center retrospective comparison study of all children less than one year of age who underwent enterostomy closure (2018-2020) with SSI diagnosed through a prospective surveillance program, using criteria from Public Health England (PHE). Demographics and risk factors, types of SSI, systemic sepsis, mortality and length of stay were compared between SSI and non-SSI. Significant factors associated with SSI were analyzed in a multivariate binomial logistic regression model.Results: Eighty-nine stoma closures were performed, most commonly for necrotizing enterocolitis (NEC) and anorectal malformation. Fourteen had SSI (16%): 12 superficial and two deep; three developed systemic sepsis, but no 30-day mortality. Surgical site infection was associated with NEC (12/14 vs. 32/75; p = 0.003), younger age (median 76 vs. 89 days; p = 0.014), lower corrected gestation (cutoff: 39 weeks gestation; 11/14 vs. 27/75; p = 0.004) and lower weight (cutoff: 2.2 kg; 7/14 vs. 16/75; p = 0.032), compared with non-SSI. After correcting for age, gestation, and weight, logistic regression showed NEC was an independent predictor for SSI (odds ratio OR], 12; 95% confidence interval CI],1.2-125). The at-risk cohort (n = 56; 63%) had seven-fold increased risk of SSI and four-fold longer hospital stay, which may be the target for SSI-reduction strategies.Conclusions: Necrotizing enterocolitis-related stoma closure is at increased risk for SSI. Considerations for delaying stoma closure until achieving 39 weeks gestation or 2.2 kg in weight may further reduce SSI. Targeting SSI-reduction strategies using these criteria may improve resource-rationalization.
| Item Type: | Article |
|---|---|
| Funders: | Royal Alexandra Children's Hospital of Brighton and Sussex |
| Uncontrolled Keywords: | infant; necrotizing enterocolitis; risk factors; stoma; surgical bundle; surgical site infection |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RD Surgery |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 29 Oct 2024 07:15 |
| Last Modified: | 29 Oct 2024 07:15 |
| URI: | http://eprints.um.edu.my/id/eprint/45564 |
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