Patient selection: high prevalence of gynecologic malignancies
Outcome: superficial, deep or organ space infection within 30 days of surgery
Risk factor from multivariate analysis:
(1) duration of surgery
Additional risk factors from bivariate analysis:
(1) obesity
(2) higher Charlson comorbidity score
(3) immunosuppression
(4) ASA Grade >= 3
(5) history of surgery within the past 60 days
(6) antibiotic prophylaxis with clindamycin and gentamicin
(7) surgery involving the omentum or gastrointestinal tract
(8) >= 4 surgeons in the operating room
(9) greater blood loss
(10) >= 7 catheters or invasive devices when in the operating room
(11) greater length of the hospital stay
where:
• Operations with a long duration tended to be for malignancy and to involve additional risk factors 7, 8, and 10.
• Greater blood loss may be associated with blood transfusion.
Protective factors from bivariate analysis:
(1) laparoscopic or robotic surgery (versus open)
(2) antibiotic prophylaxis with cefazolin
All patients received preoperative antibiotic prophylaxis.
