Nosocomial abscess. Results of an eight-year prospective study of 32,284 operations
M. M. Olson and M. O. Allen
Department of Surgery, Veterans Administration Medical Center, Minneapolis, MN 55417.
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
would infection. Excessive expense and high mortality warrant infection
surveillance for both wound infection and ongoing nosocomial abscesses.
