Surgical Site Infections in Abdominal Surgeries - A Clinicopathological Prospective Study

Abstract

BACKGROUND Surgical site infection still remains a nightmare for most surgeons even in these times despite many advances in medical science, surgical techniques & better operating room environment. Surgical site infection (SSI) is defined as ‘an infection occurring within 30 days of a surgery (or within 1 year if an implant is left in place after procedure) and affecting either incision or deep tissues at the operation site. METHODS A single observer, cross sectional, prospective study was carried out in the Dept. of General Surgery, in collaboration with Microbiology & Pathology Departments of Hi-tech Medical College and Hospital, Bhubaneswar, Odisha. The study included all patients who underwent laparotomy during the period of study, patients of all age groups except neonates and patients with post-operative surgical site infections. RESULTS The prospective study involved culture and sensitivity of 114 patients undergoing clean-contaminated surgeries (group A), contaminated-surgeries (group B) in the Department of Surgery at our institute. The study shows that the maximum number of cases were between 21 to 60 yrs. of age. (78 %) and the mean age in the group A was 39.2 years while in group B, it was 39.8 years. There was a total of 90 patients between 21 - 60 yrs. of age. Mean hospital stay in group A was 5.7 days and group B was 8.9 days. The sex ratio is quite evenly matched, 63 male patients and 51 female patients out of 114 cases. Amongst the 114 subjects, group A comprised of 58.77 % (67) while group B consisted of 41.22 % (47.13) patients. Out of 67, 13 from group A came back as sterile, in group B sterile samples were 10. CONCLUSIONS This study concludes that age, sex, class of wound, peri-operative management, operating time and co-morbidities of the patient, all have a significant effect on the incidence of surgical site infections. KEYWORDS Surgical Site Infection, Laparotomy, Purulent Discharge, Drain