Surgical site infections following abdominal surgery: incidence, risk factors and outcomes

Abstract

Background: Abdominal surgeries especially open surgeries are associated with high risk of surgical site infections. This invariably leads to increased morbidity, prolonged hospital stay with its attendant financial burden and mortality. Objectives: To describe the incidence, risk factors and outcome in patient with surgical site infection following open abdominal surgery. Methods: This was a prospective study involving consecutive 100 patients across surgical sub-specialties and gynaecology over 6 month period. Variables analyzed included; biodata, type of surgery, American Society of Anaesthesiologists (ASA) grade, hair removal at wound site, specialty, degree of intraoperative contamination, presence of surgical site infection (SSI) and mortality. Results: Majority of the patients (64%) were women and the age range was 11 to 73 years, mean age was 36.41 ± 10.9 years. About 60% of the cases were emergency procedures, indication for surgery were benign in 89 (89%) patients, malignant in 7% and trauma in 4%. Majority (55%) had clean-contaminated wounds while 45% had contaminated and dirty wounds, 54% were solely general surgery patients, 66% of the patients had hair removal before theatre arrival. SSI was recorded in 20% of the patients and mortality rate was 7% at 30 days follow up.The risk of SSI was higher in emergency procedures, (p =0.041) with an odd ratio of 2. SSI risk increases with the ASA grade, general surgical procedures, hair removal at wound site before theatre arrival and also in contaminated and dirty wounds. Emergency procedures and SSI were found to increase the odds of mortality. Conclusion: Emergency procedures, general surgery (bowel surgeries), and significant degrees of intraoperative contamination are associated with higher risk of SSI, which is an independent predictor of mortality. More efforts should be put in place to prevent SSI in these categories of patients.