Imperatori A, et al. - Researchers sought to determine the incidence of as well as factors that confer risk for surgical site infections (SSI) (wound infection, pneumonia, empyema) in a monocentric series of patients undergoing lung resection over a decade. Findings reported that over the decade, post-lung resection SSI rates were stable but the observed 11.4% frequency of SSI was suggestive of its significance and mortality burden imposed by this entity. Taking care of perioperatively modifiable SSI risk factors may improve surgical outcomes.

Methods

• In this study, researchers prospectively enrolled all patients undergoing lung resection at their institution in 2006–2015 [wedge resection, n=579; lobectomy, n=472 (12% after chemo/radiotherapy); pneumonectomy, n=40 (47% after chemo/radiotherapy)].
• They recorded perioperative SSI risk factors: age, gender, blood haemoglobin, lymphocyte count, serum albumin, forced expiratory volume in 1 second percentage (FEV1%) of predicted, antibiotic prophylaxis, length of stay, diabetes, malignancy, steroid therapy, induction chemo/radiotherapy, resection in 2006–2010/2011–2015, urgent/elective procedure, videothoracoscopic/open approach, resection type, operative time.
• They also prospectively recorded SSIs diagnosed within 30 days from surgery and assessed association with risk factors.

Results

• Data showed that 124 (11.4%) of the 1,091 resected patients [median age, 65 (range, 13–91) years; male, 74%; malignancy, 65%] developed one or more SSI.
• Findings demonstrated that wound infection, pneumonia and empyema rates were respectively 3.2%, 8.3% and 1.9%, stable through the decade.  
• Researchers found that 4.8%, 17.4% and 35.0% were the overall infection rates after wedge resection, lobectomy and pneumonectomy, respectively.
• The documented 30-day postoperative mortality was 0.6%; of the 7 deaths, 4 were causally related with SSI.
• For overall SSI, diabetes, preoperative steroids, induction chemo/radiotherapy, missed antibiotic prophylaxis and resection type were identified as independent risk factors, in multivariable analysis.