WOUND-INFECTION AFTER ABDOMINAL HYSTERECTOMY - EFFECT OF THE DEPTH OFSUBCUTANEOUS TISSUE

OBJECTIVE: Our purpose was to determine the effect of the depth of the subcutaneous tissue at the operative site on abdominal wound infectio n after hysterectomy. STUDY DESIGN: A prospective study was performed of women undergoing abdominal hysterectomy and not receiving antibioti c prophylaxis who underwent maximum vertical measurement of their subc utaneous incisions before the abdominal cavity was surgically entered. Additional demographic and perioperative data previously associated w ith wound infection were collected and analyzed. Surgical technique wa s standardized among the three attending surgeons involved. RESULTS: W ound infection occurred in 17 of 150 (11.3%) women undergoing abdomina l hysterectomy. Univariate analysis identified the following risk fact ors as being significantly associated with wound infection: depth of s ubcutaneous tissue (p = 0.0004), preoperative serum albumin (0.0015), weight (p = 0.0029), and body mass index (p = 0.0032). Logistic regres sion analysis confirmed the thickness of the subcutaneous tissue as th e only significant risk factor for wound infection (p = 0.04) (odds ra tio 1.37, 95% confidence interval 1.01 to 1.86). No patients with a ma ximum depth of subcutaneous tissue <3 cm had a wound infection. CONCLU SION: We conclude that the depth of subcutaneous tissue is the most si gnificant risk factor associated with abdominal wound infection after hysterectomy.