>Background: Significant portions of patients undergoing colorectal surgical procedures have minor incision disturbances, yet very few meet definitions for surgical site infection (SSI). We sought to investigate the natural history of incision disturbances with a focus on the patient experience and resource utilization. We hypothesize that patients who have an incision disturbance consume frequent healthcare resources in the post-operative period despite the fact that most never receive a diagnosis of SSI.>Methods: A 24-month prospective observational study was undertaken at an academic institution. Patients undergoing elective colorectal operation by two board-certified colorectal surgeons were followed prospectively for 90 days. Incisions were photographed serially and clinically characterized beginning as early as post-operative day two and at follow-up visits. The primary outcome was patient concern for an incision disturbance. Three surgeons reviewed clinical data and photographs to determine the presence of an incisional surgical infection, and diagnosis required agreement from two of three surgeons.>Results: There were 171 patients included; 31 (15%) sought evaluation from a healthcare provider for concerns related to their incision including 46 telephone calls, six emergency department visits, seven primary care visits, 10 home health and 40 surgical clinic visits. Incision erythema and drainage were the most common sources of patient concern. Mean body mass index was higher in patients with concern for incision disturbances (34 vs. 28 kg/m2, p < 0.0001). Ultimately, 8% (14/171) received a diagnosis of SSI by study criteria while only 2% (4/171) were captured as having an SSI by the institutional National Surgical Quality Improvement Program database (p < 0.0001).>Conclusions: Patients undergoing colorectal surgical procedures commonly are concerned with post-operative incision disturbance, yet few are associated with a diagnosis of SSI, and in-person evaluation yields frequent utilization of healthcare resources. This presents an opportunity for secure electronic communication with the surgical team and the patient to potentially reduce consumption of healthcare resources.
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机译：>背景：接受结直肠外科手术的患者中，有相当一部分患者切口切口较小，但很少有人达到手术部位感染（SSI）的定义。我们试图研究切口干扰的自然历史，重点是患者的经验和资源利用。我们假设有切口障碍的患者尽管大多数人从未接受过SSI的诊断，但在手术后仍要消耗大量的医疗资源。>方法：一个学术机构。由两名经董事会认证的结直肠外科医师进行的择期结直肠手术患者均接受了为期90天的随访。从手术后第二天开始以及随访时对切口进行连续拍照并进行临床表征。主要结果是患者对切口干扰的关注。三名外科医生检查了临床数据和照片以确定是否存在切口手术感染，并征得三名外科医生中的两名的同意。>结果：其中包括171例患者。 31（15％）要求医疗保健提供者评估与切口相关的问题，包括46次电话，6次急诊就诊，7次初级保健就诊，10次家庭保健和40次外科诊所就诊。切口红斑和引流是引起患者关注的最常见原因。切开障碍患者的平均体重指数较高（34 vs. 28 kg / m 2 ，p <0.0001）。最终，根据研究标准，有8％（14/171）被诊断为SSI，而美国国家外科质量改善计划数据库仅将2％（4/171）捕获为SSI（p <0.0001）。>结论：接受结直肠外科手术的患者通常与术后切口干扰有关，但很少与SSI的诊断有关，亲自评估会频繁利用医疗资源。这提供了与手术团队和患者进行安全电子通信的机会，从而有可能减少医疗资源的消耗。
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