Clinical studies and reflection of postoperative surgical site infection in gastric cancer / 中华消化外科杂志

ABSTRACT

Surgical site infection (SSI) is one of the most prevalent hospital-acquired infections in patients with gastric cancer. It is related to prolonged hospital stay, postoperative mortality and overall poor outcomes. Despite significant progress has been made in reducing the incidence of SSI, it proceeds to be a challenging and costly surgical complication. SSI is primarily caused by pathogens inoculated from the patient's flora at the time of surgery, which depending on the bacteria exposed and the host's ability to control bacterial contamination of the surgical wound. Factors influencing the incidence of SSI include age, gender, innate immune system of patients, as well as history of radiotherapy and chemotherapy, nutritional status, extent of overweight, history of diabetes mellitus and history of smoking. Surgery-related factors such as the operation time, surgical techniques, mode of anesthesia and surgical approach (open surgery or laparoscopic surgery) also impact the incidence of SSI. It can decrease the incidence of SSI by using antibiotics, skin disinfec-tion, nutritional support, glucose management before the surgery, by temperature control, hyperoxia, incisional and abdominal irrigation and closure during the surgery, and by wound protection and dressing use after the surgery. Through literature review, the authors find that the relevant guidelines for SSI prevention are inconsistent. It is suggested that implementing of these preven-tative methods should base on institutional and surgeon preferences, and using a normative approach to make a decision.