Surgical site infection in a tertiary care centre-an overview - A cross sectional study

• Published in: International journal of surgery open Vol. 21; pp. 12 - 16
• Main Authors: Saravanakumar, R., Devi, B. M. Pabitha
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 2019
• Subjects: Antibiotic sensitivity; Clean contaminated wound; Elective surgery; Emergency surgery; Surgical site infection; Surgical site infection; Clean contaminated wound; Emergency surgery; Elective surgery; Antibiotic sensitivity
• ISSN: 2405-8572; 2405-8572
• DOI: 10.1016/j.ijso.2019.09.008

Surgical Site Infections (SSIs) are the third most frequently reported nosocomial infection, accounting for 14 to 16 percent of all nosocomial infections among hospitalized patients according to National Nosocomial Infections Surveillance. SSIs are responsible for the increased morbidity and mortality related to surgery. Surgical wounds are classified as clean, clean contaminated, contaminated and dirty wounds as per CDC criteria. Better understanding of the causal factors of SSIs and prevention will reduce the cost of the surgery. 1570 patients who underwent surgery in the dept. of General surgery in a tertiary care hospital were taken for the study. Out of which 990 patients underwent elective surgical procedures and 580 underwent emergency procedures. An elaborate study of these cases with regard to date of admission, history, clinical features, type of surgery, emergency or elective, preoperative preparation, type of incision, contamination, procedure done, peroperative findings, drain used and its type and duration of operation and postoperative management and signs of wound infection were done and the findings are tabulated. 115 cases out of 1570 surgeries had surgical site infections. The overall post-operative SSI rate in elective clean and clean contaminated cases is 4.34% and emergency cases is 12.41%. The study showed that the superficial surgical site infections are the commonest type and accounted for about 72.09% in elective and 61.11% in emergency of all the SSI's and deep surgical site infection accounted for about 23% in elective and 30.55% in emergency cases. E. Coli is the commonest organism isolated from the surgical wounds that is 30.23% in elective cases. In emergency cases Proteus mirabilis is the most common organism involved in SSI followed by E. Coli. E. coli is the commonest organism isolated from elective surgical wounds and Proteus mirabilis is the commonest organism isolated from emergency surgical wounds. A change in the pre operative antibiotics may reduce the incidence even lower. A preexisting medical illness like diabetes mellitus and duration of operating time, class of the wound, emergency surgeries and wound contamination had strong effect on the development of surgical site infection. •The post-operative SSI rate in elective cases is 4.34% and emergency cases is 12.41%, with overall SSI rate of 7.32%.•As age increases the risk of occurrence of SSIs increases.•Diabetes is a strong risk factor for the development of SSI irrespective of the type of surgery.•E. Coli is the commonest organism isolated from surgical wounds in elective cases and Proteus mirabilis in emergency cases.•Proteus was sensitive to aminoglycosides and cephalosporin and E. Coli to Piperacillin, clavulanic acid and cephalosporin.