Factors Associated with Surgical Wound Infection in Patients for Elective Clean Surgery at the “Rafael Ángel Calderón Guardia” Hospital, Costa Rica

Aim: Hospital surgical wound infection (SWI) is one of the three most frequent causes of nosocomial infection worldwide, leading to high social and medical costs. This study aims to identify and quantify risk factors for SWI in a Costa Rican hospital. 

Methods: A cohort study of 488 elective patients operated between April and June 2006. The patients were divided in 2 groups: those in which operating room traffic was restricted, group A, and those in which it was not, group B. The statistical analysis was performed in 2 major phases: descriptive and analytical. In the first one, frequency measures (absolute and relative) were calculated; and the second one was carried out in 2 stages; both of them through unconditional logistic regression, univariate and multivariate analysis. 

Results: An overall incidence of 35.2 % (172/488) of SWI was found. The cumulative incidence in the unexposed was 31.8% (76/239), while in those exposed, it was 38.6% (96/249) (p=0.12). Only organ and bone/joint surgery presented a higher risk of SWI (OR 2.42; 95% CI:1.5-3.8), surgeries in unrestricted traffic rooms and diabetes had no association with the infection. 

Conclusion: Diabetes and depth of surgery should be taken into account in the profile of patients with increased risk of suffering SWI; furthermore, even though there was no epidemiological association between restricted operating room traffic and not restricted, and SWI, although the difference in incidence of SWI, was not statistically significant, it is advisable to restrict the transit of persons in operating rooms, according to international standards.