Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation
Objectives Surgical site infection (SSI) complicates 5% of all surgical procedures in the UK and is a major cause of postoperative morbidity and a substantial drain on healthcare resources. Little is known about the incidence of SSI and its consequences in women undergoing surgery for gynaecological...
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BMJ Publishing Group
2019-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/1/e024853.full |
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| author | Rachel L O’Donnell Georgios Angelopoulos James P Beirne Ioannis Biliatis Helen Bolton Melissa Bradbury Elaine Craig Ketan Gajjar Michelle L Mackintosh Wendy MacNab Thumuluru Kavitha Madhuri Mark McComiskey Eva Myriokefalitaki Claire L Newton Nithya Ratnavelu Sian E Taylor Amudha Thangavelu Sarah A Rhodes Emma J Crosbie Richard J Edmondson Yee-Loi Louise Wan |
| author_facet | Rachel L O’Donnell Georgios Angelopoulos James P Beirne Ioannis Biliatis Helen Bolton Melissa Bradbury Elaine Craig Ketan Gajjar Michelle L Mackintosh Wendy MacNab Thumuluru Kavitha Madhuri Mark McComiskey Eva Myriokefalitaki Claire L Newton Nithya Ratnavelu Sian E Taylor Amudha Thangavelu Sarah A Rhodes Emma J Crosbie Richard J Edmondson Yee-Loi Louise Wan |
| author_sort | Rachel L O’Donnell |
| collection | DOAJ |
| description | Objectives Surgical site infection (SSI) complicates 5% of all surgical procedures in the UK and is a major cause of postoperative morbidity and a substantial drain on healthcare resources. Little is known about the incidence of SSI and its consequences in women undergoing surgery for gynaecological cancer. Our aim was to perform the first national audit of SSI following gynaecological cancer surgery through the establishment of a UK-wide trainee-led research network.Design and setting In a prospective audit, we collected data from all women undergoing laparotomy for suspected gynaecological cancer at 12 specialist oncology centres in the UK during an 8-week period in 2015. Clinicopathological data were collected, and wound complications and their sequelae were recorded during the 30 days following surgery.Results In total, 339 women underwent laparotomy for suspected gynaecological cancer during the study period. A clinical diagnosis of SSI was made in 54 (16%) women. 33% (18/54) of women with SSI had prolonged hospital stays, and 11/37 (29%) had their adjuvant treatment delayed or cancelled. Multivariate analysis found body mass index (BMI) was the strongest risk factor for SSI (OR 1.08[95% CI 1.03 to 1.14] per 1 kg/m2 increase in BMI [p=0.001]). Wound drains (OR 2.92[95% CI 1.41 to 6.04], p=0.004) and staple closure (OR 3.13[95% CI 1.50 to 6.56], p=0.002) were also associated with increased risk of SSI.Conclusions SSI is common in women undergoing surgery for gynaecological cancer leading to delays in discharge and adjuvant treatment. Resultant delays in adjuvant treatment may impact cancer-specific survival rates. Modifiable factors, such as choice of wound closure material, offer opportunities for reducing SSI and reducing morbidity in these women. There is a clear need for new trials in SSI prevention in this patient group; our trainee-led initiative provides a platform for their successful completion. |
| format | Article |
| id | doaj-art-d6cc22f629c14285aa11085dab5da027 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-d6cc22f629c14285aa11085dab5da0272025-02-06T01:20:09ZengBMJ Publishing GroupBMJ Open2044-60552019-01-019110.1136/bmjopen-2018-024853Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluationRachel L O’Donnell0Georgios Angelopoulos1James P Beirne2Ioannis Biliatis3Helen Bolton4Melissa Bradbury5Elaine Craig6Ketan Gajjar7Michelle L Mackintosh8Wendy MacNab9Thumuluru Kavitha Madhuri10Mark McComiskey11Eva Myriokefalitaki12Claire L Newton13Nithya Ratnavelu14Sian E Taylor15Amudha Thangavelu16Sarah A Rhodes17Emma J Crosbie18Richard J Edmondson19Yee-Loi Louise Wan202 Northern Gynaecological Oncology Centre, Gateshead Foundation NHS Trust, Newcastle, UK4Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK2Division of Gynaecological Oncology, St James’s Hospital, Dublin, Ireland1 SGRN, Surgical Gynaecological Oncology Research Network, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK1Gynaecological Oncology, Hospital Universitari Vall d’Hebron, Barcelona, Spain3Gynaeoncology, Belfast Health and Social Care Trust, Belfast, United Kingdom14 Nottingham University Hospitals NHS Trust, Nottingham, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK16 Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford, UK7 St Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK2The Christie NHS Foundation Trust, Manchester, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UK1Department of Gynaecologic Oncology, St James’s University Hospital and Institute of Oncology, Leeds, UK14 Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UKGynaecological Oncology Research Group, Division of Cancer Sciences, 5th Floor Research, St Mary`s Hospital, The University of Manchester, Manchester, UK1 SGRN, Surgical Gynaecological Oncology Research Network, UKGynaecological Oncology, University of Manchester Faculty of Biology, Medicine and Health, Manchester, UKObjectives Surgical site infection (SSI) complicates 5% of all surgical procedures in the UK and is a major cause of postoperative morbidity and a substantial drain on healthcare resources. Little is known about the incidence of SSI and its consequences in women undergoing surgery for gynaecological cancer. Our aim was to perform the first national audit of SSI following gynaecological cancer surgery through the establishment of a UK-wide trainee-led research network.Design and setting In a prospective audit, we collected data from all women undergoing laparotomy for suspected gynaecological cancer at 12 specialist oncology centres in the UK during an 8-week period in 2015. Clinicopathological data were collected, and wound complications and their sequelae were recorded during the 30 days following surgery.Results In total, 339 women underwent laparotomy for suspected gynaecological cancer during the study period. A clinical diagnosis of SSI was made in 54 (16%) women. 33% (18/54) of women with SSI had prolonged hospital stays, and 11/37 (29%) had their adjuvant treatment delayed or cancelled. Multivariate analysis found body mass index (BMI) was the strongest risk factor for SSI (OR 1.08[95% CI 1.03 to 1.14] per 1 kg/m2 increase in BMI [p=0.001]). Wound drains (OR 2.92[95% CI 1.41 to 6.04], p=0.004) and staple closure (OR 3.13[95% CI 1.50 to 6.56], p=0.002) were also associated with increased risk of SSI.Conclusions SSI is common in women undergoing surgery for gynaecological cancer leading to delays in discharge and adjuvant treatment. Resultant delays in adjuvant treatment may impact cancer-specific survival rates. Modifiable factors, such as choice of wound closure material, offer opportunities for reducing SSI and reducing morbidity in these women. There is a clear need for new trials in SSI prevention in this patient group; our trainee-led initiative provides a platform for their successful completion.https://bmjopen.bmj.com/content/9/1/e024853.full |
| spellingShingle | Rachel L O’Donnell Georgios Angelopoulos James P Beirne Ioannis Biliatis Helen Bolton Melissa Bradbury Elaine Craig Ketan Gajjar Michelle L Mackintosh Wendy MacNab Thumuluru Kavitha Madhuri Mark McComiskey Eva Myriokefalitaki Claire L Newton Nithya Ratnavelu Sian E Taylor Amudha Thangavelu Sarah A Rhodes Emma J Crosbie Richard J Edmondson Yee-Loi Louise Wan Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation BMJ Open |
| title | Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation |
| title_full | Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation |
| title_fullStr | Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation |
| title_full_unstemmed | Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation |
| title_short | Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation |
| title_sort | impact of surgical site infection ssi following gynaecological cancer surgery in the uk a trainee led multicentre audit and service evaluation |
| url | https://bmjopen.bmj.com/content/9/1/e024853.full |
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