preoperative risk factors contributing to surgical site infections after elective and emergent colorectal surgery

Background: surgical site infections (ssis) are associated with an increased hospital stay and a significant healthcare burden. recognition of risk factors might help prevent it. methods: patients referring to the colorectal department of imam khomeini hospital complex for elective or emergent surgery were evaluated from january 2018 to 2019. all variables known to be associated with ssi were investigated. results: total number of 473 patients with a mean age of 55.6±13.9 years (range 18-88 years) and a male to female ratio of 1.4 were evaluated. overall, 103 patients developed ssi within 30 days after surgery, representing an incidence rate of 21.7%. seventy-seven percent of patients with ssi were in the age group under 65 years; 42% were female, and 58% were male. there were 89 cases of superficial (86%), 11 cases of deep (10%), and 3 cases of organ/space surgical site infection (3%). the risk factors significantly associated with ssi development were diabetes mellitus, operation on the rectum, emergency surgery, history of neoadjuvant chemotherapy, laparoscopy approach changed to laparotomy approach, colostomy/ileostomy implantation or closure, blood transfusion after surgery, anastomotic leakage, and surgery lasting more than 200 minutes. after multivariate analysis, neoadjuvant chemoradiotherapy, emergent surgery, operation on the rectum, postoperative blood transfusion, and prolonged operation to discharge periods were significantly associated with a remarkably higher ssi risk. conclusion: ssi is a devastating condition that compromises surgical outcomes. preventive measures should be applied in every surgical facility to prevent ssi and minimize its complications.