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Phenotype submission - Surgical wound infection

Cohort Definition Name: Surgical wound infection
Contributor name: Andreas Weinberger Rosen
Contributor OrcId: 0000-0001-9990-8155
Logic Description: First event surgical wound infection
Recommended study application: exposure, outcome, indication. The cohort definition includes one broad definition of surgical wounds and one where the concepts are likely not involved in colorectal surgery
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
Surgical wound infection - narrow for colorectal cancer.txt (7.7 KB)
Surgical wound infection - broad.txt (4.4 KB)

Target Clinical Description

Surgical wound infection refers to the invasion, colonization, and multiplication of pathogenic microorganisms in the surgical incision or deeper tissues accessed during an operative procedure. This complication can manifest in the immediate postoperative period or weeks after the surgery, potentially leading to delayed wound healing, abscess formation, and even systemic infection.
Presentation of Surgical Wound Infection

Common presentations for surgical wound infection include:

  • Localized redness, warmth, and swelling around the surgical site
    
  • Purulent discharge or drainage from the wound
    
  • Fever and chills
    
  • Increased pain at the surgical site
    
  • Elevated white blood cell count
    

Assessment for Surgical Wound Infection

  • Physical examination of the wound for signs of infection
    
  • Culture and sensitivity tests from wound swabs or drainage
    
  • Blood tests including complete blood count and inflammatory markers
    
  • Imaging studies such as ultrasound or MRI may be considered for deeper infections
    
  • Surgical consultation for potential wound debridement or drainage
    

Differential Diagnosis of Surgical Wound Infection

  • Hematoma or seroma at the surgical site
    
  • Allergic reaction to surgical materials or sutures
    
  • Cellulitis unrelated to the surgical site
    
  • Non-infectious wound inflammation
    
  • Systemic infection with localized symptoms
    

Treatment Plan for Surgical Wound Infection

The primary treatment involves antimicrobial therapy tailored to the identified pathogen, along with wound care that may include drainage or debridement. In severe cases or those not responding to antibiotic therapy, surgical intervention may be required to remove infected tissues. Supportive care like pain management and antipyretics can also be administered.
Prognosis for Surgical Wound Infection

The prognosis for surgical wound infection varies based on the timeliness of diagnosis and intervention, as well as the pathogenicity of the infecting organism. Early identification and treatment usually lead to favorable outcomes. However, delayed or inadequate treatment can result in systemic infection, chronic wounds, or the formation of abscesses and fistulas, significantly affecting morbidity and even leading to mortality. The patient’s overall health, surgical complexity, and presence of comorbid conditions also influence the prognosis.

Assignment for Peer Review:

Peer review of the phenotype would be more than welcome

Narrow: Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 809 in the next release. Thank you

Broad: Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 852 in the next release. Thank you

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