OBJECTIVE To conduct continuous targeted surveillance on patients undergoing pancreatoduodenectomy in a three-A comprehensive hospital, to understand the current status of postoperative surgical site infection (SSI), identify risk factors and provide references for effective prevention and control measures.
METHODS A targeted surveillance of SSI was conducted on 812 patients who underwent open pancreatoduodenectomy in the General Surgery Department of Qilu Hospital of Shandong University from 2020 to 2023. Statistical analysis was performed on various indicators, the incidence rate of SSI.
RESULTS There were 42 cases of SSI in patients undergoing pancreatoduodenectomy, with an incidence rate of 5.17%. Among them, there were 2 cases of deep surgical incision infection and 40 cases of organ (or lacuna) infection. There was no statistically significant difference in the incidence rate of SSI across different years, but there was a decreasing trend over the years (P=0.227). Multivariate logistic regression analysis showed that incision cleanliness (contamination) and intraoperative blood loss (>250 ml) were risk factors for SSI, while the tumor location (pancreas) was a protective factor for SSI (P < 0.05). The surgeon-specific infection incidence rate ranged from 0.00% to 20.00%, with the highest infection rate observed in Surgeon No. 1 (20.00%). After adjustment, the top three surgeons with the highest specific infection rates were Surgeon No. 1 (50.00%), Surgeon No. 5 (34.49%) and Surgeon No. 20 (32.05%). Among the samples from 42 patients with SSI, 70 pathogenic bacteria were detected, mainly Escherichia coli (18.57%) and Enterococcus faecium (14.29%). The hospital stay for patients with SSI after surgery was 25.00 (20.00, 34.00) days, while the hospital stay for patients without SSI was 19.00 (16.00, 24.00) days. Patients had an extended hospital stay of 6 days due to SSI (P < 0.001).
CONCLUSIONS SSI in patients undergoing pancreatoduodenectomy is mainly organ (or lacuna) infection. Incision cleanliness (contamination) and intraoperative blood loss (>250 ml) can increase the incidence rate of SSI in patients undergoing pancreatoduodenectomy. The specific infection rates vary among different surgeons, with the main pathogenic bacteria causing SSI being E. coli and E. faecium. The occurrence of SSI prolongs patients′ hospital stay.
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