The risk of surgical wound infection after vascular surgery is affected by the number of risk factors present.
Risk factors identified by logistic regression analysis:
(1) site of surgery
(2) circumstances for the operation
(3) diabetes mellitus
(4) history of previous vascular surgery
(5) antibiotic prophylaxis regimen used
|
Risk Factor |
Finding |
Points |
|
site of surgery |
not involving lower extremities |
0 |
|
|
involving lower extremities |
1 |
|
circumstances for the operation |
elective |
0 |
|
|
emergency |
0 |
|
|
delayed |
1 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
history of previous vascular surgery |
absent |
0 |
|
|
present |
1 |
|
antibiotic prophylaxis |
short regimen (3 doses) |
0 |
|
|
long regimen |
1 |
where:
• The short antibiotic prophylactic regimen consisted of 3 doses of cefamandole (1.5 grams IV at induction of anesthesia; 750 mg IV at 4 hours and 8 hours after the first dose)
• The long antibiotic prophylactic regimen (1.5 grams IV at induction and then 750 mg IV every 6 hours for 48 hours)
number of risk factors =
= SUM(points for risk factors)
Interpretation:
• minimum score: 0
• maximum score: 5
• The risk of surgical wound infection increases as the number of risk factors increase.
|
Number of Risk Factors |
Risk of Surgical Wound Infection |
|
0 |
0% |
|
1 |
2.5% |
|
2 |
3.4% |
|
3 |
7.2% |
|
4 or 5 |
54% |
A short regimen for antibiotic prophylaxis was as effective as the long regimen if 0 or 1 risk factor were present. If 2 or more risk factors (other than the choice of antibiotic prophylactic regimen) were present, then the long regimen was indicated.
Specialty: Infectious Diseases
ICD-10: ,
