March 1989

Nosocomial AbscessResults of an Eight-Year Prospective Study of 32284 Operations

Author Affiliations

From the Department of Surgery (112), Veterans Administration Medical Center, Minneapolis.

Arch Surg. 1989;124(3):356-361. doi:10.1001/archsurg.1989.01410030106018

• This article details the results of 114 abscesses found after 32 284 operations during a 30-day prospective infection surveillance. Abscesses occurred more often after gastric/esophageal (3.6%), colonic/appendiceal (2.8%), and pancreatic/biliary (1.5%) operations. Abscesses were intra-abdominal (58%), pelvic/perineal (31%), and retroperitoneal (3%). The most common pathogens were Escherichia coli, enterococci, and Bacteroides organisms. Abscess symptoms appeared 10±6 days (mean ±SEM) after surgery and were drained 8±8 days after onset of symptoms. Hospital stay from onset of symptoms to discharge was four times greater than that for wound infection. Twenty-seven patients (28%) died. Mortality was increased in patients older than 50 years and in those with renal failure or multiple abscesses. Nosocomial abscesses had a greater morbidity than wound infection. Excessive expense and high mortality warrant infection surveillance for both wound infection and ongoing nosocomial abscesses.

(Arch Surg 1989;124:356-361)