A 62-Year-Old Man Comes to the Office Due to Increasing

A 62-year-old man comes to the office due to increasing discomfort and bulging at the right groin.  He was previously diagnosed with a direct inguinal hernia but had no operative repair.  The patient recently had acute bronchitis with an incessant dry cough, which caused the hernia to enlarge.  He has had no abdominal pain, nausea, vomiting, or constipation.  Medical history includes hypothyroidism, seasonal allergy, and several previous episodes of sinusitis.  Medications are levothyroxine and a glucocorticoid nasal spray.  The patient smokes a pack of cigarettes daily and drinks alcohol occasionally.  Vital signs are within normal limits.  BMI is 24 kg/m².  Physical examination shows a nontender, easily reducible groin mass.  Surgical hernia repair is planned.  Which of the following most increases the risk for postoperative wound infection in this patient?

A) Body mass index
B) Comorbid conditions
C) Medications
D) Prior infections
E) Smoking history

Correct Answer:

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