Causes of postoperative wound infections in 57 patients undergoing hepatobiliary surgery and preventive measures

OBJECTIVE To investigate the causes and preventive measures for postoperative wound infections in the patients undergoing the hepatobiliary surgery so as to prevent the incision infections.METHODS The clinical data of 708 patients who underwent the hepatobiliary surgery from Feb 2003 to Feb 2012 were retrospectively investigated,and the causes for the incision infections were analyzed,the appropriate preventive measures were proposed.RESULTS Of 708 patients undergoing the hepatobiliary surgery,the incision infections occurred in 57 cases with the incidence rate of 8.05%.The infection rate of the diabetic patients was 20.48%.The infection rates of the patients with the total bilirubin ≥ 171μmol/L,white blood cell count ≥10×109/L,and hemoglobin content ≤ 10 g/L were 10.88%,12.07%,and 10.94%,respectively.The incidence rates of the incision infections in the patients with the preoperative length of stay more than 3 days,operation duration more than 3 hours,laparotomy,without using povidone-iodine to rinse the incision,intraoperative use of blood products,and postoperative drainage were 11.19%,28.85%,13.35%,29.76%,19.90% and 13.67%,respectively.The postoperative wound infection rates that were in line with the above conditions were significantly higher(P0.05).The infection rates of the patients with the operation duration less than 2 hours and the patients without postoperative complications were 2.05% and 4.25%,significantly lower than those of the patients with the operation duration more than 2 hours and the patients with postoperative complications the uifference was statisticacy signifiunt(P0.05).There were no incision infections that occurred in the patients with circular incision,more than 10 cm of the length,and the duration of postoperative drainage less than 5 days,and the incision infection rate was comparatively low(P0.05).The multivariate logistic regression analysis showed that the operation duration,surgical incision classification,blood loss,use of povidone-iodine to rinse the incision,and the complication were closely related to the incidence of the postoperative incision infections. CONCLUSION The incidence of incision infections is related to the patients themselves and the hepatobiliary surgery,according to the causes and the various conditions of the patients,the effective prevention measures should be taken and the incision management should be attached great importance so as to effectively reduce the incidence of incision infections and improve the prognosis of the patients.