572. Incidence of Surgical Site Infection (SSI) Associated with Robotic Surgery
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Robotic surgery is a promising minimally invasive surgery option associated with less blood loss and shorter recovery than open surgery. However, few data are available addressing SSIs in robotic surgery. The aims of this study were to determine the duration of surgery and incidence of SSIs in patients undergoing robotic surgery at a 689-bed academic medical center and compare the SSI rates to open procedures according to national data.
Methods: A retrospective cohort study from 2000-2007 included all patients receiving surgery via the DaVinci surgical system. SSIs were defined and procedure types were classified by National Healthcare Safety Network (NHSN) criteria. National data for comparison were from 1992-2004. Due to small sample size, procedures were grouped by surgical site or wound classification.
Results: In total, 273 patients were included. The overall SSI rate was 5.86%. SSI rate by procedure group is shown in Table 1. Mean surgical duration was 332 minutes. Those with SSI had a significantly longer mean surgical duration versus those without SSI (558 vs. 318 minutes, p<0.0001). Of 16 total SSIs, 9 (56.25%) were superficial and 7 (43.75%) were organ/space infections.
Table 1.
Procedure Groups NSSI rate/100 cases
(95% CI)
National Average
BILI, CHOL90 (0-29.92)1.09
CBGB, CBGC, OCVS220 (0-14.87)3.6
GAST, OGIT412.44 (0.43-12.6)4.42
PRST, OGU1225.74 (2.81-11.37)0.85
HYST, VHYS, OOB2010 (2.79-30.1)1.72
OES, NEPH372.70 (0.48-13.82)0.7
COLO633.33 (9.68-70)5.88
HER742.86 (15.82-74.95)1.62
OBL60 (0-39.03)1.9
Clean745.4 (2.1-13.1)3.47
Clean/Contaminated1986.1 (3.5-10.3)2.59

BILI, CHOL = liver/pancreas/cholecystectomy; CBGB, CBGC, OCVS = cardiovascular; GAST, OGIT = gastric/digestive; PRST, OGU = prostate/genitourinary; HYST, VHYS, OOB = hysterectomy/obstetric; OES, NEPH = endocrine/nephrectomy; COLO = colon; HER = herniorrhaphy; OBL = hem/lymph
Conclusions: Robotic surgery was associated with higher SSI rates than national data for open procedures in genitourinary, obstetric, colon, and herniorrhaphy sites and in clean/contaminated procedures. Larger sample sizes are needed to clarify these findings.
Elizabeth Hermsen, PharmD1, Tim Hinze, PharmD2, Mark Rupp, MD, FIDSA3, Harlan Sayles, MS3, Lee Sholtz, RN4 and  E. D. Hermsen,
The Nebraska Medical Center Role(s): Employee, Employee, Employee, Received: Salary.
Ortho McNeil Role(s): Consultant, Consultant, Consultant, Received: Consulting Fee.
Pfizer Role(s): Research Relationship, Speaker's Bureau, Research Relationship, Speaker's Bureau, Research Relationship, Speaker's Bureau, Received: Research Grant, Speaker Honorarium.
American College of Clinical Pharmacy Role(s): Research Relationship, Research Relationship, Research Relationship, Received: Grant Recipient.
Cubist Role(s): Scientific Advisor (Review Panel or Advisory Committee), Scientific Advisor (Review Panel or Advisory Committee), Scientific Advisor (Review Panel or Advisory Committee), Received: Consulting Fee.
Forest Laboratories Role(s): Scientific Advisor (Review Panel or Advisory Committee), Scientific Advisor (Review Panel or Advisory Committee), Scientific Advisor (Review Panel or Advisory Committee), Received: Consulting Fee.
TheraDoc, Inc. Role(s): Research Relationship, Research Relationship, Research Relationship, Received: Research Grant.
T. Hinze, None..
H. Sayles, None..
L. Sholtz, None..
M. E. Rupp, None., (1)Cubist, Omaha, NE, (2)The Nebraska Medical Center, Omaha, NE, (3)University of Nebraska Medical Center, Omaha, NE, (4)The Nebraska Med Ctr

Disclosures:

E. Hermsen, None

T. Hinze, None

M. Rupp, None

H. Sayles, None

L. Sholtz, None