Incidence and predictors of surgical site infection in patients undergoing elective colorectal resection

To identify the incidence and risk factors for surgical site infection [SSI] after elective colorectal resection. Surgical site infection [SSI] is a potentially morbid and costly complication following major colorectal resection. There has been growing attention placed on the accurate identification and monitoring of such complications, measured in terms of morbidity to patients and increased financial costs to society. Over a 3-year period at a Mansoura university hospital, data on all elective colorectal resections were retrospectively collected. The outcome of interest was a diagnosis of incisional SSI. Variables associated with infection, were collected and analyzed for their association with SSI development Multivariate analysis was then performed on those variables to determine their prognostic significance. One hundred eighty four patients underwent colorectal resection were identified for evaluation. The mean patient age was 66.6 + 6.81 years and 57% were men. Preoperative diagnosis included colorectal cancer [61.4%], inflammatory bowel disease [15.8%], polyposis [12.5%] and diverticulitis [10.3%]. Twenty one patients [11.5%] were diagnosed with SSI. Of all perioperative and operative characteristics, increased body mass index [BMI], intraoperative hypotension, contaminated wound, prolonged operative time and postoperative blood transfusion independently predicted incisional SSI. Surgical wound class, increased BMI, intraoperative hypotension, postoperative transfusion and prolonged operative time were predictors of SSI after elective colorectal resection

Early oral feeding versus delayed oral feeding in patients undergoing intestinal resection

Aim: This study was conducted to evaluate early oral feeding versus delayed feeding after intestinal resection

Methods: In the period from June 2005 to September 2006 this study included 240 patients who underwent intestinal resection either elective or emergency, they were randomized into two groups. Group [A] included 120 patients with early oral feeding and group [B] with delayed oral feeding. Patients were followed lip for a period of 3-12 months

Results: Twenty four [20%] patients in group [A] had leakage versus 28 [23.3%] in [B], [p0.531]. Sixteen [13.3%] patients were explored in group [A] versus 18 [15%] in [B], [p= 0.711]. In group [A] 15 [12.5%] patients had local complications versus 14 [11.3%] in [B], this was not of statistical significance. Hospital stay was significantly shorter in group A than [B] with mean stay of [2.5 + 1.7] versus [9.93 + 2.60] days respectively. General complications were less frequent in group [A] versus [B] with more patient satisfaction and early return to work, but readmissions were more frequent among group [A] [5 versus 2]. Regarding mortality 9 [7.5%] patients died in group [A] versus 8 [6.6%] in [B], [p= 0.333]

Conclusion: Early oral feeding after intestinal resection is well tolerated and safe with better outcome