Abdominal wall thickness as a predictor of surgical site infection after colorectal procedures in a Mexican cohort




Ana V. Espinosa de los Monteros-González, Servicio de Cirugía General, Centro Médico Nacional de Occidente Lic. Ignacio García Téllez, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México
Ricardo Hernández-Ibarra, Servicio de Cirugía de Colon y Recto. Centro Médico Nacional de Occidente Lic. Ignacio García Téllez, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México
Jose V. Pérez-Navarro, Servicio de Cirugía General, Centro Médico Nacional de Occidente Lic. Ignacio García Téllez, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México
Óscar E. Olvera-Flores, Servicio de Cirugía de Colon y Recto, Centro Médico Nacional de Occidente Lic. Ignacio García Téllez, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México


Objective: Surgical site infection (SSI) is one of the most common complications in surgery, principally in the setting of colorectal procedures. Several risk factors have been identified, including obesity. However, when using body mass index as a reference, the association is equivocal due to inter-individual variability. Therefore, recent studies have proposed abdominal wall thickness (AWT) as a more objective and accessible marker of obesity. Method: We conducted a unicentric retrospective cohort study at a high specialty center in Mexico to describe the role of AWT measured on preoperative computed tomography as a predictor of SSI in Mexican patients undergoing either elective or urgent colorectal procedures between January and November 2022. Results: Sixty patients were included without demographic differences. Twelve cases (20%) presented with SSI. All patients received antibiotic prophylaxis. AWT, urgent surgery and administration of mechanical bowel preparation showed difference in univariate analysis, but only AWT remained significant after multivariate analysis (OR: 10.67; CI: 1.79-63.44; p = 0.009). Conclusions: AWT greater than 25 mm is an independent predictor of SSI in Hispanic population after colorectal surgery, being an accessible parameter to identify patients at higher risk and implement individualized preventive strategies.



Keywords: Abdominal wall thickness. Surgical site infection. Colorectal surgery. Antibiotic prophylaxis.