Lake et al identified risk factors associated with surgical site infection (SSI) after a hysterectomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from Yale University in New Haven, Connecticu.

Patient selection: hysterectomy


Risk factors for superficial SSI (cellulitis):

(1) laparotomy

(2) prolonged operative time (> 75th percentile)

(3) ASA class 3, 4 or 5

(4) body mass index >= 40 kg per square meter

(5) diabetes mellitus


A total vaginal hysterectomy (TVH) was associated with the lowest rate of superficial SSI. Laparoscopy was associated with a rate of superficial SSI between laparotomy and TVH.


Risk factors for deep or organ site SSI:

(1) ASA classs 3, 4 or 5

(2) current smoker

(3) history of cerebrovascular accident (stroke) with neurologic deficit

(4) preoperative anemia (hematocrit < 36%)

(5) body mass index >= 40 kg per square meter

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