Factors predicting surgical site infection after clean contaminated surgery

Background: The infection of a wound is defined as the invasion of organisms through tissues following a breakdown of local and systemic host defences, leading to cellulitis, lymphangitis, abscess and bacteraemia. Southampton criteria and the centers for disease control and prevention criteria for the diagnosis of surgical site infections are used now for severity assessment. There is still controversy existing on the multifactorial causal relationship.Methods: Longitudinal Observational study with nonrandom purposive sampling carried out in the patients in OT, Casuality, ICU and Wards, in our hospital having clean contaminated abdominal operations for one-year period starting from November 2015 determine the factors responsible for surgical site infections following clean contaminated abdominal operations with prophylactic antibiotics(n=150).Results: Diabetes mellitus (odds ratio of 1.9) and emergency procedure (12.6%) were the most important risk factors for development of SSI. E. Coli (45%, n= 9) was the most common organism. Midline incision (n=6/22 = 27.27%) showed highest rate. Other high-risk factors are obesity, malnutrition, anemia, old age and prolonged duration of surgeries.Conclusions: Various host factors like malnutrition, obesity, patients knowledge about hygiene, presence of co-morbidity etc. coupled with environmental factors such as condition of the wounds, delay to initiate operation, duration of operation, prolonged exposure of peritoneal cavity to environment, prophylactic use of antibiotics and factors associated with surgery like type of incision, type of operation and experience of operating surgeon greatly contribute to occurrences of SSI. So, quality of surgical care including immediate assessment of patients, resuscitative measures, adequate preparation of patients and aseptic environment are important for control of SSI. Moreover, in absence of highly advanced surgical amenities, preoperative resuscitative units, modern operation theatre facilities and sophisticated sterilization procedure it is necessary to use prophylactic antibiotics to encounter the various types of micro-organisms responsible for surgical site infection, particularly E. coli.

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A CLINICAL STUDY ON FACTORS RESPONSIBLE FOR SURGICAL SITE INFECTIONS FOLLOWING EMERGENCY NONTRAUMATIC ABDOMINAL OPERATIONS

10.36106/ijar/0210624 ◽

2021 ◽

pp. 19-22

Author(s):

Balaji Karnasula ◽

Rakesh B ◽

Kamala Priya Tata

Keyword(s):

Environmental Factors ◽

Surgical Site Infection ◽

Infection Rate ◽

Prolonged Exposure ◽

Surgical Site Infections ◽

Host Factors ◽

Site Infection ◽

Co Morbidity ◽

Abdominal Operations ◽

Duration Of Operation

This study aims at nding out the common organisms responsible for surgical site infections following emergency non - traumatic abdominal operations and their sensitivity patterns of the microorganisms were ascertained. Determination of factors responsible for infections to reduce the infection rate and thereby reduce the morbidity and mortality. The patients admitted to various surgical wards in KIMS General Hospital, who are operated for emergency non -traumatic abdominal operations are included in this study. A proforma for study of all consecutive patients of emergency non-traumatic abdominal operations will be used. Culture and sensitivity of the organism at the surgical site infection are documented. Various statistical and epidemiological parameters used will be are mean and standard deviation. It was revealed that, overall surgical site infection rate was17.14 per cent. It was observed that among the various host factors studied age, sex, and educational status of the patients were not statistically signicant, but presence of comorbidity played a signicant role in causing SSI. Among the perioperative / environmental factors category of operations, types of incisions, and delay to initiate operation did not play signicant role, but duration of operation and degree of wound contamination played statistically signicant role. It can be concluded from the ndings of the study that microorganisms that are normal inhabitants of our body are mainly responsible for surgical site infection (SSI). Various host factors like malnutrition, obesity, patients’ knowledge about hygiene, presence of co- morbidity etc. coupled with environmental factors such as condition of the wounds, delay to initiate operation, duration of operation, prolonged exposure of peritoneal cavity to environment, prophylactic use of antibiotics and factors associated with surgery like type of incision, type of operation greatly contribute to occurrences of SSI. So, quality of surgical care including immediate assessment of patients, resuscitative measures, adequate preparation of patients and aseptic environment are important for control of SSI.

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Prevalence of surgical site infections and their sensitivity patterns in elective abdominal surgeries in King George Hospital, Visakhapatnam

International Surgery Journal ◽

10.18203/2349-2902.isj20202830 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2247

Author(s):

Pratha Anantha Ramani ◽

Simhadri Uday Kiran ◽

Murali Manohar Deevi ◽

Ginni Vijay Sainath Reddy ◽

Ginjupalli Saichand ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Wound Dressings ◽

Site Infection ◽

Antibiotic Resistant ◽

Clean Contaminated ◽

King George Hospital ◽

A Prospective Study ◽

Prolonged Hospital

Background: Surgical site infections are one of the most common complications in the postoperative period leading to increased morbidity, prolonged hospital stay and reduced quality of life. The present study aims to identify the incidence of surgical site infection (SSI), risk factors, causative organisms, and their sensitivity patterns in patients who have undergone elective abdominal surgeries.Methods: A prospective study containing 200 patients who have undergone elective abdominal surgeries from May 2018 to January 2020 were evaluated. A thorough history was taken in all the patients. A detailed clinical examination and routine investigations were done. Parameters such as body mass index (BMI), diabetic status, type of surgery, wound grading, culture, and sensitivity patterns were considered. The patients underwent treatment based on their investigatory reports.Results: In the present study, 54 patients developed surgical site infection, and among them, 22 are diabetics. Only ten patients with normal BMI developed SSI, whereas the other 44 patients who developed SSI had abnormal BMI. The incidence of SSI was higher in clean-contaminated surgeries comprising up to 89% of cases. Staphylococcus aureus was the most commonly isolated organism, and cefoperazone plus sulbactam was the most sensitive on antibiogram.Conclusions: The surgical site infections are on rising trend due to the emergence of antibiotic-resistant microorganisms. Treatment of the underlying risk factors, regular wound dressings, and antibiotics, according to sensitivity patterns, are the mainstay.

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Evaluation of various pre and postoperative parameters associated with types of surgical site infections in abdominal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20190016 ◽

2019 ◽

Vol 6 (2) ◽

pp. 432

Author(s):

Shabi Ahmad ◽

Abhinav Agrawal ◽

Shivam Madeshiya ◽

Roshni Khan ◽

Pradeep Kumar Singh

Keyword(s):

Surgical Site Infection ◽

Hospital Stay ◽

Surgical Site Infections ◽

Signs And Symptoms ◽

Site Infection ◽

Case Scenario ◽

Average Hospital ◽

E Coli ◽

Control And Prevention ◽

Clean Contaminated

Background: Surgical Site Infections (SSIs) contributing to substantial rate of mortality, significant morbidity, considerable prolongation in length of hospitalization and added treatment expenses. The Centers for Disease Control and Prevention (CDC) has classified Surgical site infections (SSI) into superficial, deep, or organ/space SSIs. The objective of study was to evaluate pattern of surgical site infection in various abdominal surgeries.Methods: All patients who admitted in surgical OPD/emergency and undergoing abdominal surgical procedures were included in study. Patients were observed in wards and during follow up to assess signs and symptoms of surgical site infection.Results: Result were analysed in terms of etiology, distribution of cases based on case scenario, wound type, clinical features, number of re-explorations done after development of SSI, type of surgery (laparoscopic v/s open), type of organisms cultured, mortality, co-morbid condition, number of extra days in hospital after SSI and average amount spent after SSI.Conclusions: Surgical site infection is associated with high incidence of morbidity in terms of treatment cost and hospital stay. Average hospital stay, expenditure, co-morbidities and mortality were more in organ/space SSI. Superficial SSI is most common in both laparoscopy and open procedures. Deep and organ/space SSI not seen with laparoscopy. Superficial SSI were more common in clean and clean contaminated cases while superficial SSI was more common in contaminated and dirty cases. In superficial and deep SSI staphylococcus aureus was more common whereas in organ/space SSI E. coli and pseudomonas were common bacterial isolates.

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GAMBARAN KEJADIAN INFEKSI LUKA OPERASI (ILO) PASCA BEDAH ABDOMEN DI RSUD ABDUL WAHAB SJAHRANIE SAMARINDA

Jurnal Kebidanan Mutiara Mahakam ◽

10.36998/jkmm.v8i1.68 ◽

2020 ◽

Vol 8 (1) ◽

pp. 21-37

Author(s):

Sepriani indriati Azis ◽

P.M.T. Mangalindung Ompusunggu ◽

Hadi Irawiraman

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Abdominal Surgery ◽

Surgical Site Infection ◽

Staphylococcus Epidermidis ◽

Surgical Site Infections ◽

Prophylactic Antibiotics ◽

Site Infection ◽

Surgical Wound ◽

Duration Of Surgery

Infeksi luka operasi (ILO) adalah infeksi pada bagian tubuh yang terpapar oleh ahli bedah saat prosedur invasive. ILO merupakan salah satu infeksi nosokomial yang paling umum dan paling dapat dicegah diantara infeksi nosokomial lainnya, namun kejadian infeksi luka operasi terutama pada bedah abdomen masih menunjukkan beban yang signifikan. Faktor resiko infeksi luka operasi meliputi usia tua, jenis luka operasi, penyakit penyerta seperti diabetes mellitus, pemberian antibiotik profilaksis yang tidak adekuat, status gizi pasien seperti obesitas dan malnutrisi serta durasi operasi yang panjang. Penelitian ini bertujuan untuk mengetahui gambaran kejadian infeksi luka operasi pasca bedah abdomen di RSUD Abdul Wahab Sjahranie Samarinda. Metode penelitian ini adalah penelitian deskriptif laboratorik. Data penelitian diambil dari swab luka operasi dan data rekam medik pada 40 pasien pasca bedah abdomen yang melakukan pergantian perban pertama kali serta memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan 30 orang (75%) pasien mendapatkan infeksi luka operasi. Mayoritas pasien terinfeksi berusia diatas 40 tahun, yaitu pada 15 pasien (37,5%). Sebagian besar pasien terinfeksi mendapatkan luka bersih terkontaminasi, yaitu 23 pasien (57,5%). Mayoritas pasien terinfeksi yaitu 27 pasien (67,5%) tidak memiliki penyakit penyerta. Bakteri gram positif, yaitu Staphylococcus epidermidis merupakan bakteri penginfeksi terbanyak yang teridentifikasi pada 10 orang (33,3%) pasien. Seluruh pasien terinfeksi, yaitu 30 pasien (75%) mendapatkan antibiotik profilaksis. Mayoritas pasien terinfeksi memiliki status gizi normal, yaitu 17 orang (42,5%), dan kejadian infeksi lebih banyak terjadi pada pasien dengan durasi <120 menit, yaitu 20 orang (50%) pasien. Kata Kunci : Infeksi Luka Operasi, ILO, Bedah Abdomen, Faktor Resiko Infeksi Luka Operasi Surgical site infection (SSI) is an infection at the part of the body that was exposed by a surgeon during an invasive procedure. SSI is one of the most common and most preventable nosocomial infection among other nosocomial infections, but the incidence of surgical site infections especially in abdominal surgery still shows a significant burden. Risk factors of surgical site infections include old age, type of surgical wound, comorbidities such as diabetes mellitus, inadequate prophylactic antibiotics, nutritional statuses such as obesity and malnutrition and long duration of surgery. This study aimed to explain an overview of the incidence of postoperative abdominal wound infection in Abdul Wahab Sjahranie General Hospital, Samarinda. This research method was a laboratory descriptive study. The research data was taken from surgical wound swabs and medical record data of 40 post-abdominal surgery patients who made the bandage changes for the first time and met the inclusion and exclusion criteria. The results showed 30 patients (75%) had surgical site infections. The highest percentage of infected patients aged over 40 years, i.e. in 15 people (37.5%). Most of the infected patients had clean contaminated wounds, i.e. in 23 patients (57.5%). The majority of infected patients did not have concomitant diseases, i.e. 27 people (67.5%). Gram-positive bacteria, specifically Staphylococcus epidermidis was the most infectious bacteria identified in 10 patients (33.3%). All infected patients, i.e. 30 patients (75%) received prophylactic antibiotics. The highest frequencies of infected patients had normal nutritional status, i.e.17 patients(42.5%), and the incidence of infection was more common in patients with duration <120 minutes, i.e. 20 patients (50%). Keywords : Surgical Site Infection, SSI, Abdominal Surgery, Risk Factors

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Study of efficacy of short course peri-operative antibiotics in clean contaminated surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20173207 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2455

Author(s):

Shivakumar C. R. ◽

Mohammad Fazelul Rahman Shoeb ◽

Anil Reddy Pinate

Keyword(s):

Surgical Site Infection ◽

Infection Rate ◽

Surgical Site Infections ◽

Cost Effective ◽

Site Infection ◽

Medical Sciences ◽

Short Course ◽

Perioperative Antibiotics ◽

Clean Contaminated ◽

Hospital Acquired

Background: Surgical site infection is a one of the most common postoperative complication and causes significant postoperative morbidity and mortality. WHO described Hospital acquired infections as one of the major infectious diseases having huge economic impact. Perioperative antibiotics constitute the bulk of antimicrobial consumption in any hospital. We need to adapt the policies that decrease the incidence of postoperative wound infection.Methods: Patients undergoing elective surgeries for clean contaminated cases for various causes from 15th May 2014 to 15th June 2017 under Surgical 1st Unit of District hospital Gulbarga (Affiliated to Gulbarga Institute of Medical Sciences, Gulbarga) are included in our study. During this period, a total of 216 patients participated, of which 145 were males and 71 were females. Patients received two doses of perioperative antibiotics, first dose before surgery and second dose after surgery, 12 hours apart during this period.Results: In this study, surgical site infection rate is 2.3% in clean-contaminated surgeries.Conclusions: The findings indicate that a short course of perioperative antibiotics where in first dose is given 30 minutes to one hour before surgery and second dose is given 12 hours after surgery are sufficient and efficacious as infection rate is acceptable (1%-3%).Infection rate in our study was 2.3%. It is cost-effective as well for prevention of surgical site infections in clean-contaminated surgeries in Indian surgical setup.

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An observational study of incidence of surgical site infections in gastrointestinal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20214751 ◽

2021 ◽

Vol 8 (12) ◽

pp. 3595

Author(s):

Jenishkumar Vijaykumar Modi ◽

Darshit Kalaria

Keyword(s):

Risk Factors ◽

Observational Study ◽

Surgical Site Infection ◽

Infection Rate ◽

Surgical Site Infections ◽

Site Infection ◽

Infection Rates ◽

Surgical Site Infection Rate ◽

Long Time ◽

Surgery Department

Background: This study analysed the incidence of surgical site infections in gastrointestinal surgeries and its risk factors. so this study helped us in reducing surgical site infection by avoiding or minimizing that risk factors.Methods: The present study was conducted at general surgery department, SMIMER, Surat. An observational study of 400 cases that have undergone abdominal surgery in SMIMER hospital and were followed up from the day of operation to 30 days after discharge was done.Results: The overall infection rate for a total of the 400 cases was 17.25%. The incidence rate in this study was well within the infection rates of 2.8% to 17% seen in other studies. Different studies from India at different places have shown the SSI (surgical site infection) rate to vary from 6.09% to 38.7%.Conclusions: Our study reveals that though SSIs have been widely studied since a long time, they still remain as one of the most important causes of morbidity and mortality in surgically treated patients.

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Risk of surgical site infection in patients undergoing orthopedic surgery

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000600012 ◽

2011 ◽

Vol 19 (6) ◽

pp. 1362-1368 ◽

Cited By ~ 30

Author(s):

Flávia Falci Ercole ◽

Lúcia Maciel Castro Franco ◽

Tamara Gonçalves Rezende Macieira ◽

Luísa Cristina Crespo Wenceslau ◽

Helena Isabel Nascimento de Resende ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Descriptive Analysis ◽

Surgical Site Infections ◽

Incidence Rates ◽

Site Infection ◽

Chi Square ◽

Historical Cohort ◽

Surgical Site Infection Incidence ◽

Chi Square Test

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

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Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1009 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s377-s377

Author(s):

Feah Visan ◽

Jenalyn Castro ◽

Yousra Siam Shahada ◽

Naser Al Ansari ◽

Almunzer Zakaria

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Body Mass Index ◽

Risk Factor ◽

Cesarean Section ◽

Surgical Site Infection ◽

Body Mass ◽

Surgical Site Infections ◽

Site Infection ◽

Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

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Magnitude of Surgical Site Infection and Its Associated Factors Among Patients Who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

10.21203/rs.3.rs-123625/v1 ◽

2020 ◽

Author(s):

Mequanint Bezie Walelign ◽

Tadesse Wuletaw Demissie ◽

Abaynew Honelign Desalegn

Keyword(s):

Surgical Site Infection ◽

General Hospital ◽

Surgical Procedure ◽

Surgical Site Infections ◽

Northwest Ethiopia ◽

P Value ◽

Age Group ◽

Site Infection ◽

Co Morbidity ◽

Debre Tabor

Abstract Background: Surgical site infections are the commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine the magnitude and factors associated with surgical site infections at the surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross-sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using the single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. The odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. A P-value of less than 0.05 will be considered statistically significant.Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and unable to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%). The factors existence of comorbidity and antibiotic prophylaxis was given were found to be significantly associated with the magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia, and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

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Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51148 ◽

2021 ◽

Vol 28 (2) ◽

pp. 136-141

Author(s):

Shahfinaz Mehzabin ◽

Mohmmad Mahbub Elahi ◽

Debashish Bar ◽

Banalata Sinha ◽

Tahmina Akter ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Site Infection ◽

Medical College ◽

Related Risk ◽

Microbiological Methods ◽

Duration Of Surgery ◽

History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

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