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Wound Infection After Excision and Primary Midline Closure for Pilonidal Disease: Risk Factor Analysis to Improve Patient Selection

Popeskou, Sotirios ; Christoforidis, Dimitrios ; Ruffieux, Christiane ; Demartines, Nicolas

In: World Journal of Surgery, 2011, vol. 35, no. 1, p. 206-211

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    Titre
    • Wound Infection After Excision and Primary Midline Closure for Pilonidal Disease: Risk Factor Analysis to Improve Patient Selection
    Auteur
    • Popeskou, Sotirios. Division of Visceral Surgery, Department of Surgery, CHUV, University of Lausanne, Lausanne, Switzerland
    • Christoforidis, Dimitrios. Division of Visceral Surgery, Department of Surgery, CHUV, University of Lausanne, Lausanne, Switzerland
    • Ruffieux, Christiane. Institute of Preventive and Social Medicine, Biostatistics, University of Lausanne, Lausanne, Switzerland
    • Demartines, Nicolas. Division of Visceral Surgery, Department of Surgery, CHUV, University of Lausanne, Lausanne, Switzerland
    Type de document
    • Postprint
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317994
    Summary
    Background: Excision and primary midline closure for pilonidal disease (PD) is a simple procedure; however, it is frequently complicated by infection and prolonged healing. The aim of this study was to analyze risk factors for surgical site infection (SSI) in this context. Methods: All consecutive patients undergoing excision and primary closure for PD from January 2002 through October 2008 were retrospectively assessed. The end points were SSI, as defined by the Center for Disease Control, and time to healing. Univariable and multivariable risk factor analyses were performed. Results: One hundred thirty-one patients were included [97 men (74%), median age=24 (range 15-66) years]. SSI occurred in 41 (31%) patients. Median time to healing was 20days (range 12-76) in patients without SSI and 62days (range 20-176) in patients with SSI (P<0.0001). In univariable and multivariable analyses, smoking [OR=2.6 (95% CI 1.02, 6.8), P=0.046] and lack of antibiotic prophylaxis [OR=5.6 (95% CI 2.5, 14.3), P=0.001] were significant predictors for SSI. Adjusted for SSI, age over 25 was a significant predictor of prolonged healing. Conclusion: This study suggests that the rate of SSI after excision and primary closure of PD is higher in smokers and could be reduced by antibiotic prophylaxis. SSI significantly prolongs healing time, particularly in patients over 25years