A clinical study of risk factors and the management of surgical site infections in general surgical cases at tertiary care center: A two-year observational study

Abstract

Background: Surgical site infections penetrate to depths in tissues and cause simple superficial infections to sepsis. The aim of this study is to identify the incidence rate of surgical site infections and their risk factors at the surgical section of a tertiary care center. Material and Methods: This retrospective observational study included 245 patients. The CDC class-wise breakup of would infection and the risk factors were recorded. Results: The Incidence of surgical site infections was 11.4%. 60-year aged patients showed 22.7% incidence. Malignancy observed as 31.3% incidence than without malignancy (10%) risk factor (p = 0.024). Among the origin, Lumbar sympathectomies and Breast surgery for malignancy showed the highest incidence (43.8%), followed by Genitourinary tract surgeries with 22.9%. Wound infection was more in an emergency (15.4%) than elective procedures (10.4%). The incidence rate increases from 7.9% (<1 hr) to 14.7% (1-2 hrs) regarding the duration of Surgery. The association of wound class with wound infection showed 13% (clean), 3.3% (clean-contaminated), 17.9% (contaminated) the incidence of the study. The antibiotics usage shows a strong association with wound infection (p=0.015). The most common bacteria isolated were Staphylococcus and Streptococcus, Escherichia and Klebsiella species (60% both), followed by Pseudomonas, Citrobacter, and others. Conclusion: The factors which showed a strong association with wound infection were increasing age, surgical procedure, site of operation, presence of malignancy, urinary tract infection, lower respiratory tract infections, and exposure to antibiotics. Combination of clinical and microbiological means was the common mode of detection rather than individually.

Keywords

• Wound infection
• Diabetes Mellitus
• surgical site infections
• Staphylococcus