INCIDENCE AND RISK FACTORS OF SURGICAL SITE INFECTION FOLLOWING ELECTIVE ABDOMINAL SURGERY: A PROSPECTIVE STUDY
DOI:
https://doi.org/10.48047/w1raba02Keywords:
surgical site infection, elective abdominal surgery, post-discharge surveillance, antibiotic prophylaxis, ; risk factorsAbstract
Background: Surgical site infection (SSI) is among the commonest healthcare-associated infections and a major cause of morbidity, prolonged stay and cost after abdominal surgery, with a disproportionately high burden in low- and middle-income settings. Post-discharge surveillance is essential to capture its true incidence. Objectives: To determine the 30-day incidence of SSI after elective abdominal surgery, describe the microbiological profile and outcomes, and explore associated patient- and procedure-related risk factors. Methods: A prospective observational study enrolled 100 adults undergoing elective abdominal surgery, with standardized 30-day surveillance (inpatient review, telephone and record review) and CDC-aligned SSI definitions. Associations between candidate risk factors and SSI were explored using the chi-square test, odds ratios and the independent t test. Results: Participants (mean age 49.6 ± 16.9 years; 65% male) underwent cholecystectomy (30%), hernia repair (25%), small-bowel (19%), colorectal (16%) and gastric (10%) resection; 52% open, and 71% clean-contaminated. The 30-day SSI incidence was 8.0% (8/100); 87.5% of infections were detected after index discharge. SSI depth was superficial incisional (3), organ/space (3) and deep incisional (2). Where cultured, Gram-negative organisms predominated (Escherichia coli, Klebsiella pneumoniae). SSI led to readmission in 7% and reoperation in 2%; 30-day surveillance was complete in all, with no deaths. SSI was numerically higher with obesity (12.5% vs 7.1%), diabetes (13.0% vs 6.5%), steroid use (20.0% vs 7.4%) and clean versus clean-contaminated wounds, and lower with timely prophylaxis (6.7% vs 12.0%), but none reached statistical significance given few events. Conclusion: The 30-day SSI incidence of 8% — most detected after discharge and predominantly Gram-negative — is consistent with regional data and underscores the value of structured post-discharge surveillance, timely antibiotic prophylaxis and attention to modifiable risk factors
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