A forgotten risk factor for surgical site infection: Hypocholesterolemia

Authors

  • Manjunath B. D. Department of General Surgery, Bangalore Medical College, Bangalore, Karnataka, India
  • Harindranath H. R. Department of General Surgery, Bangalore Medical College, Bangalore, Karnataka, India
  • Abdul Razak Department of General Surgery, Bangalore Medical College, Bangalore, Karnataka, India
  • Mohammed Arafath Ali Department of General Surgery, Bangalore Medical College, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182758

Keywords:

Hypocholestterolemia, Risk factors, Surgical site infection

Abstract

Background: Postoperative infection is one of the most common complications after any surgery. In the present study, surgical site infection (SSI) is described as; superficial (i.e., skin and subcutaneous tissues) and deep (i.e., fascia and muscles) infections occurring in the short term (i.e., 1-month) after surgery. The objective of this study was to detect various risk factors for SSI development.

Methods: In this study, we prospectively enrolled 217 patients undergoing spinal surgery over an 8 months period. In a prospective study from January 2017 to August 2017, 217 patients who were admitted and operated for elective hernia surgery in hospitals attached to Bangalore Medical College and Research Institute, patients with immunodeficiency disorders and obstructed hernias were excluded.

Results: Of 217 patients 35 (16.12%) patients developed SSI, multi-variant data analysis indicated that multiple factors correlated with an increased risk of SSI of which one of the important factor was hypocholesterolemia with 32.8% people developing SSI with p-value <0.01 along with Hypoalbuminemia and diabetes. Whereas other factors shuch as age had a minor role in increasing the incidence of SSI other factors such as smoking, alcoholism, gender, hypertension was found not to have much significant contribution in the development of SSI in the present study.

Conclusions: Hypocholesterolemia is one on the forgotten factors which is usually brushed aside whose consideration can lead to significant decrease in this preventable complication especially in a malnourished population presenting in a government setup.

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References

Centers for Disease Control and Prevention. Sutgical site infection. Available at https://www.cdc.gov/hai/ssi/ssi.html

Burke JP. Infection control: a problem for patient safety. N Engl J Med. 2003;348:65-6.

Anderson DJ, Kaye KS. Staphylococcal surgical site infections. Infect Dis Clin. 2009;23(1):53-72.

Tang R, Chen HH, Wang YL. Risk factors for surgical site infection after elective resection of the colon and rectum: a single center prospective study of 2809 consecutive patients. Ann Surg. 2001;234(2):181-9.

Hu J, Zhang Z, Shen WJ, Azhar S. Cellular cholesterol delivery, intracellular processing and utilization for biosynthesis of steroid hormones. Nutr Metabol. 2010;7:47.

Kirby JP, Mazuski JE. Prevention of surgical site infection. Surg Clin N Am. 2009;89(2):365-89.

Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. NEJM. 1996;334:1209-16.

Jonsson K, Hunt TK, Mathes SJ. Oxygen as an isolated variable influences resistance to infection. Ann Surg. 1988;208:783-7.

Desborough JP. The stress response to trauma and surgery. Br J Anaesthesia. 2000;85(1):109-17.

Morimoto M, Nakamura Y, Yasuda Y. Serum total cholesterol levels would predict nosocomial infections after gastrointestinal surgery. Indian J Surg. 2015;77(4):283-9.

Delgado-Rodriquez M, Medina-Cuadros M, Martinez-Gallegag. Total cholesterol, HDL-Cholesterol and risk of nosocomial infection: a prospective study in surgical patients. Infect Control Hosp Epidemiol. 1997;18(1):9-18.

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Published

2018-06-25

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Original Research Articles