-Review-

Surgical Site Infections in Gastroenterological Surgery

Akihisa Matsuda, Takeshi Yamada, Ryo Ohta, Hiromichi Sonoda, Seiichi Shinji, Takuma Iwai, Kohki Takeda, Kazuhide Yonaga, Koji Ueda, Sho Kuriyama, Toshimitsu Miyasaka and Hiroshi Yoshida

Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan

Surgical site infections (SSIs) remain one of the most common serious surgical complications and are the second most frequent healthcare-associated infection. Patients with SSIs have a significantly increased postoperative length of hospital stay, hospital expenses, and mortality risk compared with patients without SSIs. The prevention of SSI requires the integration of a range of perioperative measures, and approximately 50% of SSIs are preventable through the implementation of evidence-based preventative strategies. Several international guidelines for SSI prevention are currently available worldwide. However, there is an urgent need for SSI prevention guidelines specific to Japan because of the differences in the healthcare systems of Japan versus western countries. In 2018, the Japan Society for Surgical Infection published SSI prevention guidelines for gastroenterological surgery. Although evidence-based SSI prevention guidelines are now available, it is important to consider the appropriateness of these guidelines depending on the actual conditions in each facility. A systemic inflammatory host response is a hallmark of bacterial infection, including SSI. Therefore, blood inflammatory markers are potentially useful in SSI diagnosis, outcome prediction, and termination of therapeutic intervention. In this review, we describe the current guideline-based perioperative management strategies for SSI prevention, focusing on gastroenterological surgery and the supplemental utility of blood inflammatory markers.

J Nippon Med Sch 2023; 90: 2-10

Keywords
surgical site infection, gastroenterological surgery, prophylactic antibiotics, blood inflammatory marker

Correspondence to
Akihisa Matsuda, MD, Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
a-matsu@nms.ac.jp

Received, February 15, 2022
Accepted, April 13, 2022