018 引用文献 1） Buggy D：Can anaesthetic management influence surgical wound healing? Lancet 2000；356：355-357．PMID：10972364 2） Korol E, Johnston K, Waser N, et al：A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One 2013；8：e83743．PMID：24367612 3） Marchi M, Pan A, Gagliotti C, et al：The Italian national surgical site infection surveillance programme and its posi-tive impact, 2009 to 2011. Euro Surveill 2014；19：pii：20815．PMID：24906378 4） Pessaux P, Msika S, Atalla D, et al：Risk factors for postoperative infectious complications in noncolorectal ab-dominal surgery：a multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg 2003；138：314-324．PMID：12611581 5） de Oliveira AC, Ciosak SI, Ferraz EM, et al：Surgical site infection in patients submitted to digestive surgery：risk prediction and the NNIS risk index. Am J Infect Control 2006；34：201-207．PMID：16679177 6） Watanabe A, Kohnoe S, Shimabukuro R, et al：Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today 2008；38：404–412．PMID：18560962 7） Imai E, Ueda M, Kanao K, et al：Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery. Am J Infect Control 2008；36：727-731．PMID：18834730 8） Castro Pde T, Carvalho AL, Peres SV, et al：Surgical-site infection risk in oncologic digestive surgery. Braz J Infect Dis 2011；15：109-115．PMID：21503395 9） Isik O, Kaya E, Dundar EZ, et al：Surgical Site Infection：Re-assessment of the Risk Factors. Chirurgia 2015；110：457-461．PMID：26531790 10） Fukuda H：Patient-related risk factors for surgical site infection following eight types of gastrointestinal surgery. J Hosp Infect 2016；93：347-354．PMID：27209057 11） Culver DH, Horan TC, Gaynes RP, et al：Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991；91：152S-157S．PMID：1656747g 手術時間Study手術時間延長（＋）手術時間延長（－）WeightOdds RatioSSI（＋）TotalSSI（＋）TotalM-H, Fixed, 95% CIPessauxら（2003）4）98106293365626.70%3.89［2.91–5.22］de Oliveiraら（2006）5）872536235623.70%2.49［1.70–3.62］Isikら（2015）9）110213482255649.60%1.64［1.22–2.20］Total （95% CI）34496568100.00%2.44［2.03–2.93］Total events295237Heterogeneity：Chi2=16.94, df=2（P=0.0002）；I2=88%Test for overall effect：Z=9.58（P＜0.00001）h 術中輸血Study術中輸血あり術中輸血なしWeightOdds RatioSSI（＋）TotalSSI（＋）TotalM-H, Fixed, 95% CIFukuda（2016）10）718367016132037994.70%2.83［2.57–3.12］Isikら（2015）9）3837815443125.30%3.02［2.08–4.38］Total （95% CI）404824691100.00%2.84［2.59–3.12］Total events7561767Heterogeneity：Chi2=0.11, df=1（P=0.74）；I2=0%Test for overall effect：Z=21.97（P＜0.00001）び感染創），手術時間延長，糖尿病，肥満（BMI 30以上），術中輸血があげられ，腹腔鏡手術は，SSI発生を軽減する因子であった． しかし，リスク評価によって得られる情報に基づいた介入によって手術成績の改善を評価した報告はほとんどなく，リスク評価の有用性に関しては今後検討を行う必要がある．・SSI危険因子の評価に基づく介入によるSSI発生率の減少効果などの検討が必要であるfuture research questions
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