Risk Factors for Tissue and Wound Complications in Gastrointestinal Surgery

Surgical site infections and wound and tissue dehiscence are well-known postoperative complications in gastrointestinal surgery. The severity of these complications embraces mild cases needing local wound care and antibiotics to serious cases with multiple reoperations and a high mortality rate. In most cases, such complications prolong hospitalization, with a substantial increase in cost of care.1,2 Traditionally, local factors such as the degree of contamination and the surgical technique have been regarded as strong predictors for surgical site infection and wound dehiscence.3,4 More recent studies, however, have disregarded the significance of surgical technique, and others have identified systemic factors such as high age, gender, lifestyle, and coexisting morbidity as playing a significant role in the pathogenesis of these complications.5,6 To audit surgical outcome, a clinical database for operative risk and complications was established in 1994 at the Department of Surgical Gastroenterology, Bispebjerg Hospital.7 The database embraced variables related to the patient and lifestyle factors, characteristics of the disease, the patients’ preoperative condition, operative severity and findings, and the surgeon's level of training. The aim of this study was to identify and assess factors predictive of postoperative tissue and wound complications when adjusting for potential confounders through multiple logistic regression analysis.