Posthysterectomy infection relationship to timing after cervical conization

Identification of risk factors that are associated with an increased postoperative infection rate is important. Previous pelvic surgery, such as conization of the cervix, is a potential risk factor for posthysterectomy infection. Prospective data were collected on 539 women undergoing conization/hysterectomy in Parkland between August of 1978 and May of 1995. Prophylaxis was given prior to hysterectomy. Forty-eight women (9%) developed major postoperative infection in 52 sites. Nine (19%) developed infection after discharge from the hospital; 6 (67%) of these were pelvic abscess or infected hematoma. Infection developed in more women after abdominal than after vaginal hysterectomy (20/117 [17%] versus 28/422 [7%]; P=0.001). Any conization/hysterectomy interval from immediate up to 120 days was not associated with an increased infection rate after vaginal hysterectomy (P=0.59), whereas the interval to abdominal hysterectomy was a significant (P=0.002) risk for infection if the hysterectomy occurred up to 8 days after the conization. The prophylactic agent was related to infection and abscess formation. Surgery scheduling and prophylaxis choices are based on these data.