Background: Post-operative wound infections have been a problem since surgery was started as a treatment modality. Post-operative infections were responsible for 70-80% of deaths until Ignaz Semmelweis and Joseph Lister, in middle of 19th century, introduced methods of infection control by use of antiseptics. Objective was to study the incidence of postoperative infection in tertiary rural hospital.Methods: A hospital based cross sectional study was carried out at Department of General Surgery, SRTR Rural Government Medical College from September 2015 to August 2016 among 1250 patients. Detailed history, complete and thorough clinical examination was carried out for each and every individual included in the present study. The patients are assessed pre operatively and post operatively.Results: It was found that the maximum cases belong to the age group of 26-35 years i.e. 28.32% followed by age group of 36-45 years (25.68%). The proportion of males was slightly more than females. The most common surgical procedure done was inguinal hernioplasty in 24.96% of cases followed by internal appendectomy in 22.24% of cases. Maximum study subjects had clean surgical procedure in 62.08% of cases. The highest incidence (19.46%) was found in the age group of above 56 years followed by age more than 56 years in 19.46% of cases. It was found that the incidence of SSI was more among females than males. It was found that the incidence of SSI was more among those with some co-morbidity than among those who doesn’t have any co-morbidity.Conclusions: Surgical infections particularly, surgical site infections, have always been a major complication of surgery and trauma. The overall prevalence of surgical site wound infection in the surgical ward was 10.4%.

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

INTRODUCTIONPeptic ulcer disease (PUD) remains one of the most prevalent diseases of the gastrointestinal tract with annual incidence 1 ranging from 0.1% to 0.3% in India. Cases of peptic ulcer perforation are commonly encountered in our institute. The high incidence of mortality and morbidity associated with this condition, promoted us to carry out an in depth study of this condition. There are well known two major precipitating factors: Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) and the ulcer incidence increase with age for both duodenal and gastric ulcers. ABSTRACTBackground: Peptic ulcer disease remains one of the most prevalent diseases of the gastrointestinal tract with annual incidence 1 ranging from 0.1% to 0.3% in India. Cases of peptic ulcer perforation are commonly encountered in our institute. The objective was to study the effect of post-operative medical management on peptic ulcer in patients of perforated peptic ulcer disease. Methods: A prospective non randomized study was conducted among all diagnosed cases of peptic ulcer perforation patients admitted through emergency or OPD in surgery ward in our hospital. Patient's case record was evaluated to collect following data: personal information, past history of peptic ulcer disease, use of non-steroidal antiinflammatory drugs for heart disease or osteoarthritis was taken. Tests such as detail clinical history, patient's prescription, rapid urease test, upper GI endoscopy were done. Results: Most common age group affected is, 50 years and above. Duodenal perforations were more common in age group of 50 years and above. Most of these patients present with clinical signs of peritonitis 24 hours after onset of pain. 84% of total patients were male patients and 16% were female patients. Among the patient of peptic ulcer perforation, duodenal perforation is more common, and which is most common cause of perforation peritonitis. Guarding and rigidity was present in 84% of patients. Diagnosis is made clinically and confirmed by presence of pneumoperitoneum on radiograph. Exploratory laparotomy with simple closure of perforation with omental patch after that peritoneal lavage with normal saline is commonest operative management perforated peptic ulcer. Most common post-operative complication observed was wound infection and lower respiratory tract infection. The overall mortality was 4%. Conclusions: Perforation peritonitis is common in elderly population. Pain in abdomen and distension of abdomen are most common presenting feature. Early diagnosis by clinical assessment and presence of pneumoperitoneum is important followed by resuscitation and laparotomy with simple closure of perforation.

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