Steroids and poor nutrition are associated with infectious wound complications in children undergoing first stage procedures for ulcerative colitis

Troy A. Markel, Derek C. Lou, Marian Pfefferkorn, L. R. Scherer, Karen West, Thomas Rouse, Scott Engum, Alan Ladd, Frederick Rescorla, Deborah F. Billmire

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Abstract

Background: Risk factors for postoperative infections have not been evaluated in pediatric patients with ulcerative colitis (UC). This review was undertaken to evaluate the effects of immunosuppressive therapy and other preoperative factors on infectious wound complications in children undergoing first stage surgical therapy for UC. Methods: A 10-year retrospective review of children under 18 years of age receiving first stage surgical therapy for UC at a major children's hospital was performed. Preoperative clinical and treatment variables were identified and correlated with postoperative wound complications. Results: A total of 51 children were identified: 19 underwent colectomy with ileo-anal-pouch anastomosis and 32 underwent total abdominal colectomy with Hartmann's pouch. A total of 20 infectious complications were identified in 18 patients. Preoperative steroid use was associated with a greater postoperative wound infection rate. Preoperative hemoglobin less than 10 g/dL (P < .05) and albumin less than 3 g/dL (P = 0.1) were associated with greater rates of postoperative infection. Preoperative body mass index and other immunosuppressive agents did not influence postoperative infectious morbidity. Conclusions: The majority of pediatric patients who require operative intervention for UC are debilitated from their disease and medication use. Children with normal serum albumin and hemoglobin who are not on steroid therapy have a low risk of postoperative infectious complications.

Original languageEnglish
Pages (from-to)540-547
Number of pages8
JournalSurgery
Volume144
Issue number4
DOIs
StatePublished - Oct 2008

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Ulcerative Colitis
Steroids
Wounds and Injuries
Colectomy
Immunosuppressive Agents
Hemoglobins
Pediatrics
Therapeutics
Surgical Wound Infection
antineoplaston A10
Infection
Serum Albumin
Albumins
Body Mass Index
Morbidity

ASJC Scopus subject areas

  • Surgery

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Steroids and poor nutrition are associated with infectious wound complications in children undergoing first stage procedures for ulcerative colitis. / Markel, Troy A.; Lou, Derek C.; Pfefferkorn, Marian; Scherer, L. R.; West, Karen; Rouse, Thomas; Engum, Scott; Ladd, Alan; Rescorla, Frederick; Billmire, Deborah F.

In: Surgery, Vol. 144, No. 4, 10.2008, p. 540-547.

Research output: Contribution to journalArticle

Markel, Troy A. ; Lou, Derek C. ; Pfefferkorn, Marian ; Scherer, L. R. ; West, Karen ; Rouse, Thomas ; Engum, Scott ; Ladd, Alan ; Rescorla, Frederick ; Billmire, Deborah F. / Steroids and poor nutrition are associated with infectious wound complications in children undergoing first stage procedures for ulcerative colitis. In: Surgery. 2008 ; Vol. 144, No. 4. pp. 540-547.
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AU - Markel, Troy A.

AU - Lou, Derek C.

AU - Pfefferkorn, Marian

AU - Scherer, L. R.

AU - West, Karen

AU - Rouse, Thomas

AU - Engum, Scott

AU - Ladd, Alan

AU - Rescorla, Frederick

AU - Billmire, Deborah F.

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N2 - Background: Risk factors for postoperative infections have not been evaluated in pediatric patients with ulcerative colitis (UC). This review was undertaken to evaluate the effects of immunosuppressive therapy and other preoperative factors on infectious wound complications in children undergoing first stage surgical therapy for UC. Methods: A 10-year retrospective review of children under 18 years of age receiving first stage surgical therapy for UC at a major children's hospital was performed. Preoperative clinical and treatment variables were identified and correlated with postoperative wound complications. Results: A total of 51 children were identified: 19 underwent colectomy with ileo-anal-pouch anastomosis and 32 underwent total abdominal colectomy with Hartmann's pouch. A total of 20 infectious complications were identified in 18 patients. Preoperative steroid use was associated with a greater postoperative wound infection rate. Preoperative hemoglobin less than 10 g/dL (P < .05) and albumin less than 3 g/dL (P = 0.1) were associated with greater rates of postoperative infection. Preoperative body mass index and other immunosuppressive agents did not influence postoperative infectious morbidity. Conclusions: The majority of pediatric patients who require operative intervention for UC are debilitated from their disease and medication use. Children with normal serum albumin and hemoglobin who are not on steroid therapy have a low risk of postoperative infectious complications.

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