Szilagyi et al identified risk factors for surgical site infections associated with a vascular graft. The authors are from Henry Ford Hospital in Detroit, Michigan.
Risk factors associated with infection:
(1) "dirty" location prone to infection (such as the inguinal region)
(2) perforated hollow viscus near the graft (before or after surgery)
(3) pre-existing infection at the operative site
(4) synthetic graft material
(5) gross break in aseptic technique during the procedure
(6) septicemia (considered a rare cause on page 328)
(7) ruptured aneurysm (page 330)
(8) significant immune deficiency (page 330)
Host factors playing a minor role in infection:
(1) diabetes
(2) ischemic changes
(3) obesity
Factors reducing the risk of infection:
(1) prophylactic antibiotics (at least for "dirty" areas or if risk factors present)
(2) scrupulous skin preparation
For the implementation emergency surgery will be added as a risk factor. This is often associated with less-than-perfect skin preparation.
