An Analysis Comparing The Frequency And Severity Of Surgical Site Infections After Elective And Emergency Abdominal Surgeries In A Tertiary Care Centre, Chengalpattu

Abstract

BACKGROUND: Surgical site infections (SSI) pose a serious threat to patient’s ability to heal and resume their regular lives. SSI and its complications have been identified as one of the major causes of postoperative morbidity, specifically with regard to abdominal procedures. The best course of treatment for SSIs is prevention, which can be achieved by identifying risk factors. This enables proper classification and the implementation of precautions to protect the patient from developing SSI during the preoperative phase. The study aimed to examine the prevalence, severity, and microbiological makeup of surgical site infections that resulted from both elective and emergency abdominal surgeries.
METHODS: This prospective observational study followed patients who had laparotomies in either an emergency or elective setting (regardless of rationale) at Karpaga Vinayaga Institute of Medical Sciences and Research centre , Chengalpattu from December 2022 to September 2023. Following that, patients with SSI were categorized using the Southampton wound assessment scale and the ASEPSIS wound scoring system. Every patient's SSI type was further recorded. Additional factors that were documented in the study included the length of hospital stay, the microbiological profile, the procedures that were carried out, etc.

RESULTS: Out of the 200 cases (hundred and eleven male and eighty nine female) who were enrolled in the study, 35 patients developed SSI( 17.5% patients developed an SSI) (10 elective instances and 25 emergency cases), whereas the remaining 165 patients did not develop SSI . Ecoli was the most common organism cultured (17 cases) followed by Staphylococcus aureus (11 cases) and Pseudomonas (7 cases)
CONCLUSION: The nature of the surgery, such as whether it was elective or emergency (P-value 0.040), the type of wound (P-value 0.001), the presence of underlying malignancy (P-value 0.030), and the presence of a concurrent urinary tract infection (UTI) (P-value 0.045) were found to be significant contributors to the development of SSI. The patient's age (P-value 0.699), sex (P-value 0.108), chronic kidney disease (P-value 0.904), diabetes mellitus (DM) (P-value 0.816), and acute respiratory infection (ARI) (P-value 0.909) were not found to be associated with the development of a secondary systemic infection (SSI).