Infectious problems after elective surgery of the alimentary tract: the influence of peri-operative factors. The Norwegian Gastro-Intestinal Group (NORGAS).

A prospective multi-centre study was carried out on 1537 patients to investigate the influence of some peri-operative factors on the infectious complications after elective abdominal surgery in surgical departments where a standardized prophylactic antibiotic regimen is used regularly. The antibiotic regimen consisted of 1600 mg tinidazole and 400 mg doxycycline given intravenously 1-hour preoperatively. The results showed that total gastrectomy seemed to give higher infection rates than other gastroduodenal procedures. Low anterior and abdomino-perineal rectal resections were followed by more infectious complications than colonic resections, but this difference was significant only due to the perineal wound infections and failures of the low anterior anastomosis. Prolonged operation time was followed by increased number of infectious complications only when prophylaxis was not given. Blood transfusions led to a highly significant increase in infectious complications. Peri-operative surgical complications, splenectomy and stoma formation did not influence post-operative infectious complications.