Clinical Outcomes of enhanced recovery after surgery protocols in Patients with postoperative wound infection

Aoife Nolan; O. Gallagher; N. Gallagher

doi:10.5281/zenodo.22813381

Authors

Aoife Nolan Department of Surgical Research, Tajo Institute of Surgical Research Author https://orcid.org/9819-8959-1364-8699
O. Gallagher Department of General Surgery, Danube Institute of General Surgery Author https://orcid.org/5839-8582-8223-1182
N. Gallagher Department of Surgical Research, Brahmaputra Academy of General Surgery Author https://orcid.org/1084-6472-7269-7717

DOI:

https://doi.org/10.5281/zenodo.22813381

Keywords:

enhanced recovery after surgery, surgical site infection, wound infection, postoperative outcomes, perioperative care

Abstract

Graphical abstract

Background: Postoperative wound infection remains a common driver of prolonged hospital stay and unplanned reintervention, and Enhanced Recovery After Surgery (ERAS) protocols were designed to interrupt the perioperative stress response that predisposes to it.

Objective: To compare the incidence, severity, and clinical course of postoperative wound infection in patients managed under a structured ERAS protocol versus standard perioperative care.

Methods: In a cohort of adults undergoing elective major abdominal and pelvic surgery, patients managed with a structured ERAS pathway were compared with patients receiving standard perioperative care. Wound infections were classified by CDC criteria and graded by Clavien-Dindo severity; time to resolution, reintervention, length of stay, and 30-day readmission were recorded.

Results: Wound infection incidence, deep/organ-space infection proportion, time to clinical resolution, and postoperative length of stay were all lower among ERAS-managed patients than standard-care patients, with a within-cohort gradient linking higher ERAS compliance to better outcomes; 30-day readmission did not differ significantly between groups.

Conclusion: A structured ERAS pathway was associated with a lower incidence and severity of postoperative wound infection and faster clinical resolution, supporting closer integration of infection-prevention practice within formal ERAS protocols and explicit tracking of wound infection as a primary ERAS outcome.

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