Evaluate the spectrum of surgical site infections in general surgery patients admitted at tertiary care centre of north India

Abstract

Background

Surgical site infections (SSIs) are infections present in any location along the surgical tract after a surgical procedure. SSIs involve postoperative infections occurring at any level (incisional or deep). With this knowledge we hope to reduce the incidence of this problem in our institution and the burden borne by the patient. We also hope to sensitize other health care professionals to this problem.

Aim

To evaluate the spectrum of surgical site infections in general surgery patients

Methodology

This study included all patients admitted for surgery in the department of General Surgery at Christian Medical College and Hospital, Ludhiana between 1st November 2010 to 1st November 2011. Each patient was followed up from the time of admission till discharge from the hospital and also for 30 days postoperatively. The patients were assessed preoperatively and postoperatively. Swabs obtained from the infected wounds were processed aerobically and anaerobically by standard methods.

Results

In this study from 1st November 2010 to 1st November 2011, a total of 1041 surgeries were performed. There were 1008 major surgeries and 33 minor surgeries performed during the study period. Only inpatients were included in this study. Out of 1041 surgeries performed, surgical site infection (SSI) was detected in 47 (4.51%) patients. Escherichia coli was the predominant organism 15/27 (55.56%). Patients were divided into two arms (SSI group and Non SSI group). Patients who developed SSI were clubbed together in SSI group and those who did not develop SSI following operation were put in Non SSI group. Following observations were made and analysis was concluded accordingly. Data has also been tabulated.

Conclusion

It was found that males are more prone to develop surgical site infection. The length of preoperative hospitalization of more than 1 day was found to have direct relation with developing SSI. There was increased incidence of SSI in the patients in whom postoperative hospitalization was > 7 days. There was more risk of developing SSI in patients, who had serum albumin < 3.5 g/dl. There was increased incidence of SSI in patients in whom duration of surgery was >2 hours. There was increased incidence of SSI in patients in whom open drain was used. There was increased incidence of SSI in contaminated cases as compared to clean, clean contaminated and dirty cases. Pre-operative shaving as a method of hair removal increases the risk of developing SSI. There was increased risk of developing SSI in patients getting post-operative antibiotics for < 10 days than in patients getting post-operative antibiotics for more than 10 days. Escherichia coli (E. coli) was the commonest isolate for the postoperative wound infections.