Original CommunicationA prospective study on surgical-site infections in thyroid operation
Section snippets
Study design
This study accrued 6,784 consecutive patients who underwent thyroid surgery at the Department of Surgery at the Kaiserin-Elisabeth-Hospital, Vienna, Austria, between March 1, 2007, and October 31, 2012. During this period, the hospital participated in the German Nosocomial Infection Surveillance System (KISS) and collected prospective data on all patients undergoing surgery. Institutional review board approval was obtained. The current study includes the patients who underwent thyroid operation
Incidence of SSI
Patient characteristics are shown in Table I. In all, SSI occurred in 32 cases. The cumulative incidence of SSI after 5, 10, 20, and 30 days was 0.18%, 0.36%, 0.46%, and 0.49%, respectively (Fig 1). The median time from surgery to SSI was 7 days (IQR 4–10.5 days). Of the 32 SSI, 5 (15.6%) occurred during the hospital stay for surgery and 27 occurred after hospital discharge (84.4%). Of the latter group, 10 patients (37.0%) required re-admission to the hospital for a median of 6 days (IQR 3–11
Discussion
This study shows that the cumulative incidence of SSI is <0.5%. ASA score and the duration of operation are independent risk factors for SSI. The low incidence of SSI does not justify routine antibiotic prophylaxis, but it may be considered for selected patients based on the individual risk profile.
In our study, the incidence of SSI was 0.49% at 30 days. This rate is somewhat lower than the average rate reported in the literature (reviewed in Table IV). This may in part be attributed to the
Conclusions
The cumulative incidence of SSI in thyroid surgery is <0.5%. ASA score and the duration of operation are independent risk factors for SSI. Routine antibiotic prophylaxis is not recommended but may be considered for selected patients on the basis of our predictive model. External validation of the nomogram is advocated.
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