ABSTRACT
OBJECTIVE: To retrospectively investigate the association between the non-plan secondary surgery and the nosocomial infection so as to provide objective basis for prevention and control of nosocomial infection in the non-plan secondary surgery patients. METHODS: The medical records of all the patients who received non-plan secondary surgery in a three-A tertiary hospital of Xi'an from Jan 2018 to Dec 2019 were retrospectively investigated. The baseline data, clinical features and status of infection of the non-plan secondary surgery patients were retrospectively reviewed and analyzed by full-time staff of disease prevention and control department. RESULTS A total of 111948 patients underwent surgeries in the whole hospital from Jan 2018 to Dec 2019, 194 of whom underwent the non-plan secondary surgery, accounting for 0.17%. Postoperative hemorrhage was the leading cause of the non-plan secondary surgery, followed by incision infection(57.22%), incision dehiscence(11.34%) and poor healing(8.76%). Among the 194 patients undergoing non-plan secondary surgery, 57 had nosocomial infection, respiratory system, surgical site and blood system were the infection sites, there was 1 case who had nosocomial infection for the first time before the surgery, 24 cases who had nosocomial infection for the first time after the surgery and 32 cases who had nosocomial infection after the secondary surgery. Among the 24 patients who had nosocomial infection for the first time after surgery, 70.83% were male patients, 75.00% had clean-contaminated incision, 66.67% were with the operation duration no less than 3 hours, 75.00% were treated with preoperative antibiotic prophylaxis, and 91.67% were tumor patients. Among the 32 patients who had nosocomial infection after the secondary surgery, 75.00% were male patients, 53.13% were no less than 60 years old, 78.13% were with the operation duration no less than 3 hours, and 68.75% were tumor patients. CONCLUSION: The non-plan secondary surgery and the nosocomial infection are mutually causal, the postoperative surgical site infection for the first time may lead to the secondary surgery, and the secondary surgery may result in the increase of incidence of nosocomial infection.