An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital

Abstract

BackgroundSurgical site infections (SSI) are a potential cause of morbidity and increased cost of care after operations such as open prostatectomy.ObjectiveTo audit the occurrence of SSI after open prostatectomy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, NigeriaMethodsA review of all patients who underwent open prostatectomy over a ten-year period (July 2005 to June 2015). Data analysis was done using the statistical package for social sciences version 21. Association between variables was determined using Chi-square or Fisher's exact test as appropriate. A p-value < 0.05 was considered statistically significant.ResultsA total of 247 open prostatectomy surgeries were reviewed, with the patients' ages ranging from 43 – 91 years and a mean age of 67.0 ± 8.8 years. Elective procedures were 98.8% while the remaining 1.2% were emergency cases. There were 24 (9.8%) surgical site infections. The duration of admission of the patients with SSI ranged from 6 – 15 days with a mean of 9.5 ± 3.2 days, as against 4 – 9 days (mean of 5.0 ± 2.1days) for those without SSI. All the patients with SSI were successfully managed with no resultant mortality. Risk factors identified for SSI were emergency surgery (p=0.001), obesity (p<0.0001), diabetes mellitus (p=0.008), smoking (p<0.0001), pre-operative catheterization (p<0.0001), excessive haemorrhage (p<0.0001) and post-operative suprapubic bladder drainage (p<0.0001).ConclusionSSI is a recognized complication of open prostatectomy. Identified risk factors for its occurrence from this audit are emergency operation, obesity, diabetes mellitus, smoking, pre-operative catheterization, excessive haemorrhage and post-operative suprapubic bladder drainage. Age, approach to prostatectomy (retropubic vs transvesical), incision type (lower midline vs pfannenstiel), level of the surgeon, catheter type and modality of irrigation were however not significant risk factors for post-prostatectomy SSI in this study.

Infections: HIV and related-diseases, anti-microbial resistance and neglected tropical diseases

“…Nigerian authors report that Dengue is a growing public health problem in their country12, and that levels of stigma against Buruli ulcer disease are high13. On the surgical front, Salako et al report that 10% of patients who underwent prostatectomy in a Nigerian Teaching Hospital suffered from a surgical site infection14, while Omorogiuwa et al report that Cymbopogoncitratus Stapf leaf is a potential treatment of male reproductive related infections15.…”