A Study Of Various Factors Influencing Surgical Site Infection Rates In A Tertiary Cancer Research Hospital

Abstract

Health Care-Associated Infections (HAIs) remain an important public health concern. Amongst the prominent HAIs, Surgical Site Infections (SSIs) contribute to substantial rate of mortality, significant morbidity, considerable prolongation in length of hospitalization and added treatment expenses [1]. Several factors are known to increase the risk for SSIs, including obesity, advanced age, diabetes mellitus, malnutrition, prolonged preoperative stay, infection at a remote site, duration of surgery, surgery technique, presence of drains, inappropriate use of antimicrobial prophylaxis, perioperative temperature, and poor postoperative glycemic control. Optimizing perioperative conditions can certainly help decrease infection risk [2]. The SSI rates in developing countries like India are higher than those reported by CDC-NHSN but are comparable to INICC rates [3].
This study was carried out to assess the influence of the various risk factors for developing SSI so that measures could be implemented to reduce the SSI rates. The length of preoperative stay, timing of pre operative antibiotic administration, duration of antibiotic prophylaxis, and method of hair removal were some of the factors studied and they had an important role in determining the development of SSI’s.
Some of the changes which were recommended for implementation based on this study are, reducing the pre operative hospital stay, no surgical prophylaxis to be given in the wards and shifting from shaving to clipping for surgical hair removal.
Commitment at all levels of the health care system is necessary to implement these changes which can eventually reduce the incidence of SSI and thus reduce the cost burden of treating these infections.

Abbreviations: HAIs- Health Care-Associated Infections, SSIs- Surgical Site Infections, CDC-NHSN- Centers for Disease Control and Prevention-National Healthcare Safety Network, INICC- International Nosocomial Infection Control Consortium.