Surgical Site Infection and Its Risk Factors Following Abdominal Surgery: A Hospital-Based Observational Study
DOI:
https://doi.org/10.48047/ytqfhc58Keywords:
Surgical site infection, abdominal surgery, diabetes mellitus, operative time, antibiotic prophylaxis, South IndiaAbstract
Background: Surgical site infection (SSI) remains one of the most common and costly healthcare-associated infections following abdominal surgery, contributing to prolonged hospitalisation, increased morbidity, and avoidable expenditure. Reported rates are consistently higher in developing-country settings, yet contemporary data from South India are limited. This study aimed to determine the incidence of SSI following abdominal surgery and to identify associated risk factors.
Methods: A hospital-based observational study was conducted among 250 patients undergoing abdominal surgery at Tertiary Care Teaching Hospital. SSI was assessed during the period of admission using the Centers for Disease Control and Prevention (CDC) criteria. Demographic, clinical, and operative variables were recorded prospectively. Descriptive statistics were computed, and associations between potential risk factors and SSI were examined using the chi-square test for categorical variables and the independent-samples t-test for continuous variables, with a significance threshold of p < 0.05.
Results: The mean age of the cohort was 49.7 (SD 17.8) years, with near-equal sex distribution (female 50.8%, male 49.2%) and a mean body mass index of 28.7 (SD 5.8) kg/m². SSI occurred in 39 patients, yielding an overall rate of 15.6% (95% CI 11.1–20.1%). SSI was significantly associated with diabetes mellitus (21.8% in diabetics vs 9.9% in non-diabetics; χ² = 5.86, p = 0.015) and with prolonged operative time (>120 min, 20.4%; χ² = 8.66, p = 0.013), with a higher mean operative duration among SSI cases (169.7 vs 141.7 min; t = 3.02, p = 0.003). No significant association was observed with gender, smoking, ASA grade, antibiotic prophylaxis, BMI category, or age.
Conclusion: The SSI rate of 15.6% is consistent with figures reported from comparable Indian settings. Diabetes mellitus and prolonged operative time emerged as the principal identifiable risk factors. The apparent absence of benefit from antibiotic prophylaxis most plausibly reflects confounding by indication in this observational design rather than true ineffectiveness. Glycaemic optimisation and measures to reduce operative duration may help lower the SSI burden
Downloads
References
Shah S, Singhal T, Naik R. A 4-year prospective study to determine the incidence and microbial etiology of surgical site infections at a private tertiary care hospital in Mumbai, India. Am J Infect Control. 2015;43(1):59-62. doi: 10.1016/j.ajic.2014.10.002
Rana DA, Malhotra SD, Patel VJ. Inappropriate surgical chemoprophylaxis and surgical site infection rate at a tertiary care teaching hospital. Braz J Infect Dis. 2013;17(1):48-53. doi: 10.1016/j.bjid.2012.09.003
Rajkumari N, Gupta AK, Mathur P, Trikha V, Sharma V, Farooque K, et al. Outcomes of surgical site infections in orthopedic trauma surgeries in a tertiary care centre in India. J Postgrad Med. 2014;60(3):254-9. doi: 10.4103/0022-3859.138731
Fei Q, Li J, Lin J, Li D, Wang B, Meng H, et al. Risk factors for surgical site infection after spinal surgery: a meta-analysis. World Neurosurg. 2015;95:507-15. doi: 10.1016/j.wneu.2015.05.059
George AK, Srinivasan AK, Cho J, Sadek MA, Kavoussi LR. Surgical site infection rates following laparoscopic urological procedures. J Urol. 2011;185(4):1289-93. doi: 10.1016/j.juro.2010.11.059
Arveen S, Jagdish S, Kadambari D. Perforated peptic ulcer in South India: an institutional perspective. World J Surg. 2009;33(8):1600-4. doi: 10.1007/s00268-009-0056-9
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20(4):250-278.
Astagneau P, Rioux C, Golliot F, Brücker G. Morbidity and mortality associated with surgical site infections: results from the French national surveillance system. J Hosp Infect. 2001;48(4):267-274.
Anaya DA, Dellinger EP. The obese surgical patient: a susceptible host for infection. Surg Infect (Larchmt). 2006;7(5):473-480.
Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008;70(Suppl 2):3-10.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
