Patient factors as a major determinant of wound outcome and infection after surgery

Abstract

Despite major advances in the management of patients undergoing surgery-including aseptic technique, prophylactic antibiotics, and advances in surgical approaches such as laparoscopic surgery-surgical wound infection remains among the most common complications of surgery [1]. Wound complications are associated with prolonged hospitalization and increased resource consumption. More than 300,000 surgical site infections occur each year in the United States at an estimated cost of more than $1 billion [1]. A growing body of literature supports the concept that patient factors are a major determinant of wound outcome following surgery. Comorbidities such as diabetes and cardiac disease clearly contribute, but environmental stressors as well as the individual's response to stress are equally important. In particular, wounds are exquisitely sensitive to hypoxia, which is both common and preventable. Perioperative management can be adapted to promote postoperative wound healing and resistance to infection. © 2010 Springer-Verlag Berlin Heidelberg.