Surgical Site Infections Following Elective and Emergency Abdominal Surgeries in a Teaching Hospital: A Prospective Observational Cohort Study.

Rezumat

Background:

Surgical site infection remains one of the most frequent healthcare-associated complications after abdominal operations and contributes to delayed recovery, additional procedures, prolonged hospitalization, and increased treatment costs. To determine the incidence, clinical pattern, microbiological profile, and risk factors of surgical site infection following elective and emergency abdominal surgeries in a teaching hospital.

Methods:

 This hospital-based prospective observational cohort study enrolled 100 consecutive patients undergoing open abdominal surgery and followed them during the postoperative surveillance period. Demographic characteristics, comorbidities, operative variables, wound class, microbiological findings, and postoperative outcomes were recorded. Surgical site infection was identified clinically and microbiologically using standard surveillance criteria. Data were summarized descriptively, and associations between categorical variables and SSI were assessed using the chi-square test, with p < 0.05 considered significant.

Results:

Among 100 patients, the overall incidence of surgical site infection was 18.0%. Infection occurred more often after emergency than elective surgery [26.0% versus 10.0%] and increased across wound classes from clean-contaminated to dirty wounds. Perforation peritonitis had the highest procedure-specific infection rate. Diabetes mellitus, anemia, hypoalbuminemia, prolonged operative duration, contaminated or dirty wounds, and drain placement were significantly associated with infection. Most infections were superficial incisional, and Escherichia coli was the most common isolate. Patients with infection had substantially longer postoperative hospital stay and a greater need for secondary suturing and re-intervention.

Conclusion:

Surgical site infection imposed considerable postoperative morbidity in abdominal surgery, particularly in emergency and contaminated procedures. Recognition of modifiable perioperative and patient-related risk factors is essential for targeted prevention and improved surgical outcomes.

Recommendations:

Routine surveillance, strict perioperative infection-control practices, optimization of anemia and nutritional status, appropriate antimicrobial prophylaxis, and focused monitoring of high-risk abdominal procedures should be strengthened in comparable teaching hospitals.