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Article history:
Available online 13 December 2008
Background and aim: Different studies underline the importance of hospital stay on the development of
Keywords: Thyroid
surgery Surgical site
infections Wound
infection
Postoperative infections
infectious complications. We performed an audit of surgical site infections (SSI) after thyroidectomy was
performed in a one-day surgery setting.
Materials and methods: One hundred and twelve consecutive patients admitted between April 2007 and
discharged before May 2008 were studied. Patient selection criteria for one-day surgery were specic
medical and social-logistic status. The technique of thyroidectomy was standardized.
Results: SSI affect 2.6% of patients undergoing thyroid surgery with short hospitalization. The incidence
of SSI was 3.2% following thyroidectomy, 2% for lobectomy. Mean time interval to symptom onset was 3
days (range 26). Most likely organism was Staphylococcus aureus. WI was associated with prolonged
ambulatory medications.
Conclusions: Rates of SSI are similar to those described in the literature with longer hospitalization. All
SSI become evident only after patient discharge. Prevention of SSI is very much the responsibility of the
persons working in the operating theater. Effort should be made to improve sterile technique. Appropriate antibiotic coverage is indicated when infection develops postoperatively.
2008 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
1. Introduction
Downloaded from ClinicalKey.com at ClinicalKey Global Guest Users June 21, 2016.
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S14
Table
2
Morbi
dity.
N
(
%
)
Woun
d
compl
icatio
n
6
(
5
.
3
)
Hem
atom
a
Siero
ma
Infec
tion
1
2
3
electronic
Microsoft Ofce
Access
Database (Microsoft Corp,
Redmond,
Washington, USA). The database is part of
our
departments quality-improvement
program. In case of
dichotomous variables, group differences
were examined by c2 or
Fisher exact tests as appropriate. Statistical
analysis was computed with SPSS, release
15.0 for Windows (SPSS Inc, ChicagoIll,
USA). The level of signicance was set at P
less than 0.05.
4
.
R
e
s
u
l
t
s
The study group included 67 women
and 45 men with a mean age of 39.8 (age
range 1969 years). The mean thyroid
volume estimated
by
preoperative
ultrasonography was 39 (range
1165) mL. Mean size
of dominant
nodules was 3.5 cm (range
1.25.5 cm). The treated pathologies were
mainly nodular goiter and tumors (Table
1). Complete follow-up was available for
all patients. Procedures performed were 62
(55%) total thyroidecto- mies and 50 (45%)
emithyroidectomies.
No mortality was observed. Overall
morbidity was as high as
17.8% (N 20) and in most cases included
transient complications
(Table 2). No bilateral vocal cord paresis or
paralysis occurred in the
T
a
b
l
e
1
Preoperative characteristics and operative parameters
in 112 patients undergoing elective thyroidectomy in
one-day surgery.
N
a
Ag
e
Esti
mat
(y
ed
ea
by
rs)
preo
39
pera
tive
.8
ultra
(1
son
9
ogra
69
phy
)
(US
).
W
b
o
Papi
m
llar
en
y
67
carc
ino
M
ma
en
(N
45
9),
T
folli
hy
cula
ro Thyroid pathology
r
id -Non-toxic
carc
nodular goiter
vo
ino
-Follicular
nodule
ma b
lu
-Cancer
(N
m
1).
e
(
m
L)
a
39
(1
1
65
)
D
o
m
in
an
t
no
du
le
di
a
m
et
er
(c
m
)
3.5
(1
.2
5.
5)
D
at
a
ar
e
nu
m
be
rs
or
m
ea
n
wi
th
pe
rc
en
ta
ge
s
or
ra
ng
es
in
pa
re
nt
he
se
s.
Permanent
hypoparathyroidism
1 (0.9)
Permanent
RLN
injury
0
Temporary hypocalcaemia
10 (8.9) Temporary RLN injury
3 (2.6)
Total
25 (16.4%)
S15