
Study of Surgical Site Infections
in Abdominal Surgeries
935-939
Correspondence
Satyanarayana V.
Professor, Dept of Pharmacology
Raja Rajeshwari Medical College, Bangalore,
Karnataka, India.
Phone: 09845692450
E-mail: satyanarayana72@yahoo.co.in
Background: Surgical site infections (SSI) have been responsible for the increasing cost, morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities and standard protocols of pre-operative preparation and antibiotic prophylaxis.
Aims: This study aimed to determine the incidence of SSI in the abdominal surgeries and to identify risk factors associated with the development of SSI.
Settings and Design: This retrospective observational study included patients who had undergone surgeries (abdominal) in the Department of General Surgery and Department of Obstetrics and Gynacology. It was conducted over a period of 18 months.
Materials and Methods: All surgeries (1000 cases) where abdominal wall was opened were considered for the study. Wound class was considered as clean, clean contaminated, contaminated and dirty based on the extent of intraoperative contamination. The data collected includes details of timing of antimicrobial prophylaxis, surgical wound infection, types of surgeries (emergency and elective surgeries), the wound classes, apart from demographic profile of the patient.
Results: The overall surgical wound infection rate was 13.7%. The infection rate was more with emergency surgery (25.2%) when compared to elective surgery (7.6%). The surgical site infection rate increased as the risk index score increased from 0 to 3. SSI was more with early operative and post operative prophylaxis. There was definite correlation between the wound infection rate and the timing of prophylaxis. Statistical Analysis: Chi-square test was applied and the level of significance was set at 5%.
Conclusion: A pre-existing medical illness, prolonged operating time, the wound class, emergency surgeries and wound contamination strongly predispose to wound infection. Antimicrobial prophylaxis is effective in reducing the incidence of post-operative wound infections for a number of different operative procedures but, timing of administration is critical.