SSIs in children having nonemergent surgical procedures

Editor's Note

This study, led by researchers at Boston Children’s Hospital and the American College of Surgeons, finds that a small number of surgical procedures account for a disproportionate number of surgical site infections (SSIs) in elective pediatric surgery.

This multicenter analysis included SSI data from 90 hospitals and 11,689 nonemergent pediatric surgical procedures.

The highest incisional SSI rates were associated with:

• gastrostomy closure (4.1%)
• small bowel procedures (4.0%)
• gastrostomy 3.7%.

The highest organ space SSI rates were associated with:

• esophageal atresia/tracheoesophageal fistula repair (8.1%)
• colorectal procedures (1.8%)
• small bowel procedures (1.5%).

More than 66% of the cumulative incisional SSIs from all procedures were attributable to three groups:

• gastrostomy (27.5%)
• small bowel (22.9%)
• colorectal (15.7%).

Nearly 73% of all organ space SSIs were attributable to three groups:

• small bowel procedures(28.5%)
• colorectal procedures (26.0%)
• esophageal atresia/tracheoesophageal fistula repair (18.4%).

The results of this analysis can be used to prioritize and focus SSI prevention efforts where they are needed most, the researchers note.