Dear editor,
We read the article entitled “Predictive Factors for Surgical Site Infection After Colorectal Cancer Surgery” by Aydın and Soylu1 published in Turk J Colorectal Dis 2018; 28:61-8 with great interest. Despite advances in patient care and surgical technique in colorectal surgery, surgical site infections (SSI) continue to be a major cause of morbidity. Therefore, we value every study related to efforts to prevent SSI after colorectal surgery. Half of the studies conducted in Turkey have reported colorectal SSI at rates of 11% or lower.2,3,4,5,6,7 We believe these rates are underestimated for various reasons (Table 1). For this reason, we appreciate the fact that Aydın and Soylu1 reported a realistic SSI rate. In addition, we would like to ask the authors some questions and offer suggestions regarding their study.
1. Multivariate analysis would have been more accurate for determining independent variables. For example, in some studies preoperative hypoalbuminemia, operative time, and body mass index were identified as independent variables in multivariate analyses.4,6
2. Modifiable independent variables could be evaluated by ROC curve analysis and risk analysis can be done at the cut-off values.
3. Why were anaerobic antibiotics not used in elective surgeries? Did the patients perform mechanical bowel cleansing?
4. Were there no cases of organ SSI? Was there growth in cultures of the SSIs?
We thank the authors for their valuable work.
