Intraoperative haemorrhage and postoperative
bile leakage are operation-related risks associated
with the development of SSI. When the haemorrhage
was large, patients were given a perioperative
blood product transfusion. Consistent with
our finding that the presence of intraoperative
haemorrhage and postoperative bile leakage correlated
with the incidence of SSI, we showed by
univariate analysis that the perioperative usage
volume of fresh frozen plasma was greater in SSIpositive
patients. The perioperative transfusion of
leucocyte-containing allogeneic blood components
is an apparent risk factor for the development
of postoperative SSI.29 In the present study,
procedural problems, including the timing of transfusion
and the use of non-standardised SSI definitions,
limit interpretation of the available data.
There is currently no scientific basis for withholding
necessary blood products from surgical patients
as a mean of either superficial/deep
incisional SSI or organ/space SSI risk reduction.
Furthermore, in this study, because the amount
of usage of RC-MAP was very small, there was no
correlation between postoperative SSI and RCMAP.
The incidence of postoperative bile leakage
was significantly greater in the SSI-positive group
than in the SSI-negative group. Excellent surgical
technique is widely believed to reduce the risk of
SSI. Postoperative bile leakage is considered a major
postoperative complication of hepatic surgery,
and is reported in 4.8e7.6% of patients undergoing
hepatic surgery.8e14 In the present study the incidence
of postoperative bile leakage after hepatic
resection was 7.9%, which is consistent with
reports from other high volume centres.