Risk factors for surgical site infectionsin clean surgical wounds (class I)and prediction of their occurrence
Abstract
Introduction.Surgical site infections remain one of the most significant problems in modern surgery. Studying surgical site infections risk factors in clean surgical wounds (class I), where the main source of contamination is exogenous factors and factors related to the type of surgical intervention, is of particular interest.Materials and methods.Cohort studies of the outcome’s of 1619 surgical interventions of orthopedic-traumatological, cardiac, and vascular surgical profiles with class I surgical wound cleanliness were conducted. Risk factors directly related to the surgical intervention were assessed: the number of people in the operating room, the use of cardiopulmonary bypass, and implant placement. The informativeness of the NNIS index was evaluated, and a cumulative risk index was developed.Results.A tendency toward increased surgical site infections incidence was established when more than 7 people were present in the operating room across all surgical profiles. The NNIS index proved uninformative for class I clean wound operations. The developed cumulative risk index, accounting for four factors per each profile, allowed reliable patient stratification by surgical site infections risk.Conclusions.For predicting surgical site infections risk in class I clean surgical wounds, it is advisable to use a cumulative risk index incorporating profile-specific factors rather than the universal NNIS index.
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