Incidence and factors associated with surgical site infections at the Surgical Ward, National Referral Hospital, Bhutan

Abstract

Introduction: The burden related to surgical site infection (SSI) and antibiotic sensitivity of the organisms causing SSI is a cause of concern. This is the first study to assess SSI at Bhutan’s largest surgical centre. Methods: This was an observational descriptive study conducted involving patients undergoing incisional surgeries at the Department of Surgery, JDWNRH from July – December 2017 using convenient sampling. Data was collected using a pro forma. The health care workers conducted the first two wound examinations and the information on the third examination was done though phone call. Southampton Wound Score (SWS) was used to assess the postoperative wound. The Research Ethics Board of Health, Bhutan, gave ethical approval. Results: The incidence of surgical site infection was 30.7% and the most common organism was Escherichia coli. SSI occurred in Southampton Wound Grade I and IV. Contaminated (46.2%) and dirty (33.3%) wounds had higher incidence of SSI. Patients age >60 years (p= 0.049) and those with contaminated wound (p= 0.005) were significant risk factors for SSI. Hypertension, diabetes, smoking, alcohol intake and obesity, elective or emergency case, and the seniority of surgeon were not risk factors for SSI. Conclusions: The incidence of SSI is high and antibiotic sensitivity patterns a cause of concern. Strict infection control and patient safety measures need to be implemented.