Post-operative surgical site infection among general surgery patients: Rate and risk factors.

Objectives: High rate of post-surgical infections are reported with scanty effort for controlling them. The objectives were to evaluate frequency of surgical site infections in patients undergoing general surgery. Study Design: Cross Sectional Observational Study. Setting: Naz Memorial Hospital. Period: March 2019 to March 2020. Material & Methods: This study was conducted in general surgery ward for 1 year. All patients over 18 years admitted in surgery ward either as elective or emergency case were included while patients having any wound infection, operated in other hospital or diabetic foot and all those operated for incision and drainage of abscess were excluded. All patients that were operated during the study period were followed for any wound infection development till one qAqmonth. SPSS was used for data entry and analysis keeping p-value of <0.05 as significant. Results: 75 from 200 patients developed surgical site infection, 46 (61.3%) were operated in emergency. Among 24 contaminated surgeries type, 70.8% were reported having SSI (p-0.05) while from 28 dirty types of surgeries 78.6% of patients had a SSI (p-0.03). 25% were anemic, 21% diabetic while (20%) were reported to be hypertensive, 13 (17%) gave positive history of smoking while 12 (16%) were obese. Conclusion: Higher proportion of surgical site infection was observed in patients undergoing contaminated and dirty type of surgeries. Most patients with SSI were operated in emergency setting and anemia and diabetes were the most common risk factor reported in the infected patients.

Download Full-text

Role of subcutaneous suction drain in reducing surgical site infections after emergency laparotomy

International Surgery Journal ◽

10.18203/2349-2902.isj20173141 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2717

Author(s):

Poonam Gupta ◽

Rajesh Kumar

Keyword(s):

Surgical Site Infection ◽

Significant Role ◽

Surgical Site Infections ◽

P Value ◽

Emergency Laparotomy ◽

Emergency Setting ◽

Site Infection ◽

Randomised Study ◽

Suction Drain ◽

Drain Group

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous fluids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed.Methods: A prospective interventional study of 100 subjects done in department of surgery at rural tertiary centre. on the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play significant role in reducing the incidence of surgical site infection which is significant statistically.Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically significant.Conclusions: Subcutaneous drain in emergency laparotomy play significant role in reducing the incidence of surgical site infection

Download Full-text

Superficial surgical site infections following stone and non-stone bile duct surgery- A comparative analysis

Northern International Medical College Journal ◽

10.3329/nimcj.v11i2.54061 ◽

2021 ◽

Vol 11 (2) ◽

pp. 458-462

Author(s):

Chishti Tanhar Bakth Choudhury ◽

BH Nazma Yasmeen ◽

Manir Hossain Khan ◽

AHM Towhidul Alam ◽

Shirin Akhter

Keyword(s):

Bile Duct ◽

Surgical Site Infection ◽

Wound Infection ◽

Surgical Site Infections ◽

Stone Disease ◽

P Value ◽

Site Infection ◽

Causative Agents ◽

Group A ◽

Group B

Background : Superficial surgical site infection (SSSI) is a vital issue after biliary surgery. Surgical site infections remain a major cause of illness in the post-operative period. Objectives : The purpose of the present study was to compare the number of wound infection and the causative organism of surgical site infection of patient of stone and non-stone bile duct surgery. Methodology : This cross-sectional study was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2017 to April 2018 for a period of 12 months. Patients presented with biliary disease of stone and non-stone variety were selected as study population. Patients were divided into 2 groups designated as group A and group B. Patients with the biliary stone disease were enrolled in group A and the biliary nonstone disease patients were in the group B. Patients were followed up in the postoperative period up to 2 weeks to find out the incidence of wound infection and its risk factors, causative agents, and some other variables. Certain variables were closely monitored to find the postoperative outcome as these variables were standard parameters in assessment of the outcome of the study. Results : A total number of 50 patients were recruited for this study of which 25 patients were enrolled in group A and the 25 patients were enrolled in group B. Mean age was 42.48 ± 17.21 years in group A and 40.04 ± 21.37 years in group B. The difference was not statistically significant ( p=0.659). Males were predominant in both groups. Male female ratio was 1.77:1 and 1.08:1 in group A and group B respectively. Inflammatory evidence of gall bladder with pericholecystic collection was found in 5 (20%) and 6 (24%) patients in group A and group B. There was evidence of cholangitis in 8 (32%) and 4 (16%) patients in group A and group B respectively. Evidence of inflammation at the wound site, was found in 14 (56%) patients in group A and 7 (28%) patients in group B. There was statistically significant difference between these 2 groups in the incidence of superficial surgical site infection, ( p value is 0.045). Regarding per operative collected bile, we found E. Coli in 4 cases in group A and 3 cases in group B ( p value is 0.408). Klebsiella spp. was found in 1 patient in group A. Wound swab C/S identified E. Coli in 1 patient in group A. Staph aureus was found in 1 and 2 patients in group A and group B respectively ( p value is nonsignificant). Conclusion : In conclusion, there is a difference in the incidence of occurrence of surgical site infection and causative agents after stone and non-stone bile duct surgery. Stone disease has increased chance of wound infection than nonstone disease of bile ducts. Northern International Medical College Journal Vol.11 (2) Jan 2020: 458-462

Download Full-text

Incidence and risk factors for maternal surgical site infection after cesarean section.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.10.6187 ◽

2021 ◽

Vol 28 (10) ◽

pp. 1495-1500

Author(s):

Sadia Zaineb ◽

Amina Akbar ◽

Mobeen Ikram ◽

Saira Mahboob ◽

Arshad Mahmood ◽

...

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Surgical Site Infection ◽

Wound Infection ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Site Infection ◽

Cross Sectional ◽

Antenatal Visits

Objective: To ascertain the frequency and risk factors for post-operative surgical site infection (SSI) in cesarean section. Study Design: Cross-sectional study. Setting: Departments of Gynecology & Obstetrics and Anesthesiology, Secondary Care Hospital. Period: January to December 2017. Material & Methods: After the approval of hospital ethical committee, 337 parturient who underwent cesarean section were included in our study. Outcomes were: frequency and risk factors for post-cesarean wound infection. Data was analyzed by SPSS version 20. Qualitative data presented as frequency and percentage. Chi-square (Fishers test) used to analyze significance. P-value ≤ 0.05 taken as significant. Results: A total of 337 patients were included in our final analysis. The frequency of wound infection was 15 (4.4%). The mean age was 27.5 years ± 5.8 in our study population. There was no difference in age (p=0.781), parity (p=0.898), antenatal visits (p=0.319), referral from doctor (p=0.205), anemia (p=0.731), nature of surgery (elective or emergency LSCS) p=0.548, severity of anemia (p=0.962), blood grouping Rh-factor (p=0.531), chorioamnionitis (p=0.707), labor (p=0.955), premature rupture of membrane (p=0.427) and antepartum hemorrhage (p=0.769). 11 (3.3%) of the patients with SSI were treated conservatively while 4 (1.2%) required debridement and secondary suturing. None of our patients required referral to tertiary care hospital for treatment of SSI. Conclusion: The incidence of SSI after cesarean section was less in our study and we didn’t find maternal age, gestational age, previous cesareans delivery, antenatal visits, PROM, labor before LSCS, anemia to be associated with risk of SSI.

Download Full-text

ROLE OF SUBCUTANEOUS SUCTION DRAIN IN REDUCING SURGICAL SITE INFECTIONS AFTER EMERGENCY LAPAROTOMY AT SKMCH, MUZAFFARPUR, BIHAR

10.36106/ijsr/4136227 ◽

2021 ◽

pp. 54-55

Author(s):

Sanjay Kumar ◽

Kumar Vikram ◽

Manoj Kumar ◽

Debarshi Jana

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

P Value ◽

Emergency Laparotomy ◽

Emergency Setting ◽

Site Infection ◽

Randomised Study ◽

Medical College ◽

Suction Drain ◽

Drain Group

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous uids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed. Methods: A prospective interventional study of 100 subjects done in department of surgery at Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. On the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play signicant role in reducing the incidence of surgical site infection which is signicant statistically. Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically signicant. Conclusions: Subcutaneous drain in emergency laparotomy play signicant role in reducing the incidence of surgical site infection

Download Full-text

Tingkat Pengetahuan Ibu Tentang Perawatan Luka Dan Kejadian Infeksi Daerah Operasi Di RSUD Banyumas

Adi Husada Nursing Journal ◽

10.37036/ahnj.v6i2.167 ◽

2021 ◽

Vol 6 (2) ◽

pp. 75

Author(s):

Utami Purwaningsih ◽

Kris Linggardini

Keyword(s):

Surgical Site Infection ◽

Wound Care ◽

Good Health ◽

P Value ◽

Wound Infections ◽

Knowledge Level ◽

Site Infection ◽

Chi Square ◽

Cross Sectional ◽

The Relationship

Surgical Site Infection is infections that occur after surgery. Control of the incidence of nosocomial infection is part of the parameters of good health services at the hospital. One in 10 mothers who give birth by cesarean has an infection. The level of patient knowledge about how to care for wounds is an important factor in decreasing the incidence of wound infection in the surgical area in SC patients. Objective: knowing the relationship between levels of knowledge of post-operative SC patients about wound care and the incidence of surgical site wound infections. Method: The design used descriptive correlative and cross sectional approach. The sample were 76 respondents. The data were collected in December 2019 by using a knowledge level questionnaire and a form of signs of infection from Morison 2004. Data analysis using chi square). The results showed that there was a relationship between knowledge and the incidence of infection in the area of operation (p value 0.001). Keywords: nosocomial, surgical site infection (SSI), section caesarea (SC)

Download Full-text

KNOWLEDGE ON PREVENTION OF SURGICAL SITE INFECTION AMONG MEDICAL STAFF IN SON TAY GENERAL HOSPITAL, 2021

Tạp chí Y học Cộng đồng ◽

10.52163/jcm.v62i5.139 ◽

2021 ◽

Vol 62 (5) ◽

Author(s):

Tran Quynh Anh ◽

Bui Van Tung ◽

Nguyen Tuan Tai ◽

Chu Van Thang ◽

Dang Duc Hoan ◽

...

Keyword(s):

Surgical Site Infection ◽

General Hospital ◽

Medical Staff ◽

Surgical Site Infections ◽

Cross Sectional Study ◽

Site Infection ◽

Cross Sectional ◽

Ongoing Training ◽

Number Of Patients ◽

Objective Description

Objective: Description of knowledge on prevention of surgical site infections (SSIs) among medical staff in Son Tay general hospital, 2021 and some related factors.Method: A cross-sectional study was conducted on 151 medical staff.Results: The rate of medical staff with fully knowledge of SSI prevention is 36.42%, in which the rate of doctors is 38.3% and of nurses is 35.58%. Age group ≥30 (OR=2.82; 95%CI: 1.12 – 7.13);Department of Surgery (OR=13.61; 95%CI: 5.14 – 35.98); working year ≥10 (OR=2.54; 95%CI: 1.26 – 5.11) and number of patients cared for/day <8 (OR=3.43; 95%CI: 1.26 – 9 ,34) are factorsrelated to the knowledge of medical staff about regarding SSIs.Conclusion: The medical staff’s knowledge of surgical site infection prevention is suboptimal; relevant factors should be considered when conducting ongoing training in the prevention of surgical site infections in hospitals.

Download Full-text

Post-discharge surveillance of surgical site infections in teaching hospitals in Brazil

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2018038203542 ◽

2020 ◽

Vol 54 ◽

Author(s):

Amandha Fernandes Pagamisse ◽

Judith Tanner ◽

Vanessa De Brito Poveda

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

National Registry ◽

Teaching Hospitals ◽

Site Infection ◽

Online Questionnaire ◽

Post Discharge ◽

Cross Sectional ◽

Active Search ◽

Hospital Infection Control

Abstract Objective: Understanding the reality of surgical site infections post-discharge surveillance in Brazilian teaching hospitals. Method: A cross-sectional study conducted by sending an online questionnaire to nurses from the Hospital Infection Control Committee of Brazilian teaching hospitals registered in the National Registry of Health Establishments. Results: Of the 193 teaching hospitals in Brazil, eight declined to take part as they did not conduct post-discharge surveillance and 36 did not respond. Twenty five of the remaining 149 hospitals provided detailed responses and 96% of responding institutions performed surgical site infection surveillance during hospitalization; active search (29.3%) was the main method, while 84% reported performing post-discharge surveillance mainly by telephone (42.8%). Both surveillance actions have nurses as the main responsible professionals. Conclusion: Nurses play a prominent role in surgical site infection identification/screening actions, and active search during hospitalization allied with post-discharge surveillance by telephone were the preferred methods.

Download Full-text

Incidence of post operative surgical site infection in thyroid surgery following single dose of prophylactic antibiotic

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v22i1.45073 ◽

2020 ◽

Vol 22 (1) ◽

pp. 15-20

Author(s):

Md Abul Hossan ◽

Md Ariful Islam ◽

Tapas Chakraborty ◽

Firoz Ahmed Khan ◽

Md Mozharul Islam

Keyword(s):

Antibiotic Therapy ◽

Surgical Site Infection ◽

Thyroid Surgery ◽

Prophylactic Antibiotic ◽

Surgical Site Infections ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Empirical Antibiotic Therapy ◽

Site Infection ◽

Cross Sectional

Surgical site infection after thyroid surgery is a less common incidence. Prophylactic antibiotic before surgery and empirical antibiotic therapy after surgery is a common practice in our country. But international guidelines do not suggest antibiotic in clean surgical procedure. Aim: To compare the incidence of surgical site infection after thyroid surgery with and without empirical antibiotic therapy. Method: It was a cross sectional study, done from July 2010 to December 2010 in 3 medical college hospitals in Dhaka city. Total 100 cases were included in this study, 50 cases for study in which only single prophylactic antibiotic used half an hour before operation, 50 cases for control in which 7 days antibiotic used per orally in addition to prophylaxis. Result: Among 100 cases male were 24 & female 76 (M: F= 1:3.2). Oldest patient was 56 yrs & youngest 21yrs. 47% patient operated for solitary thyroid nodule, 35% multinodular goiter & only 6% diffuse goiter. 47% patient was done hemithyroidectomy & only 7% total thyroidectomy. All the operations were completed within 2 hours where 40% within one hour. No surgical site infections were found in both study and control cases. Conclusion: There is no statistical difference between routine antibiotic use and no use of antibiotic after thyroid surgery. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 15-20

Download Full-text

Single-Stage Repair of Contaminated Hernias Using a Novel Antibiotic-Impregnated Biologic Porcine Submucosa Tissue Matrix

10.21203/rs.2.14521/v4 ◽

2020 ◽

Author(s):

samuel fulton minor ◽

Carl J Brown ◽

Paul S Rooney ◽

jason p hodde ◽

lisa julien ◽

...

Keyword(s):

Surgical Site Infection ◽

Surgical Site Infections ◽

Single Stage ◽

High Rate ◽

Site Infection ◽

Small Intestine Submucosa ◽

Biologic Graft ◽

Device Infection ◽

Porcine Small Intestine Submucosa ◽

Tissue Matrix

Abstract Background: Single-stage repair of incisional hernias in contaminated fields has a high rate of surgical site infection (30-42%) when biologic grafts are used for repair. In an attempt to decrease this risk, a novel graft incorporating gentamicin into a biologic extracellular matrix derived from porcine small intestine submucosa was developed. Methods: This prospective, multicenter, single-arm observational study was designed to determine the incidence of surgical site infection following implantation of the device into surgical fields characterized as CDC Class II, III, or IV. Results: Twenty-four patients were enrolled, with 42% contaminated and 25% dirty surgical fields. After 12 months, 5 patients experienced 6 surgical site infections (21%) with infection involving the graft in 2 patients (8%). No grafts were explanted. Conclusions: The incorporation of gentamicin into a porcine-derived biologic graft can be achieved with no noted gentamicin toxicity and a low rate of device infection for patients undergoing single-stage repair of ventral hernia in contaminated settings. Trial Registration: The study was registered March 27, 2015 at www.clinicaltrials.gov as NCT02401334.

Download Full-text

ANTIBIOTIC PROPHYLAXIS IN BARIATRIC SURGERY: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000200002 ◽

2015 ◽

Vol 52 (2) ◽

pp. 83-87 ◽

Cited By ~ 4

Author(s):

Álvaro Antônio Bandeira FERRAZ ◽

Luciana Teixeira de SIQUEIRA ◽

Josemberg Marins CAMPOS ◽

Guido Correa de ARAÚJO JUNIOR ◽

Euclides Dias MARTINS FILHO ◽

...

Keyword(s):

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Continuous Infusion ◽

Prophylactic Antibiotic ◽

Surgical Site Infections ◽

Anesthesia Induction ◽

Site Infection ◽

Cross Sectional ◽

Group I ◽

Bariatric Patients

Background The incidence of surgical site infection in bariatric patients is significant and the current recommendations for antibiotic prophylaxis are sometimes inadequate. Objective The aim of this study was to analyze the effect of three prophylactic antibiotic regimens on the incidence of surgical site infection. Methods A prospective, cross-sectional study was conducted between January 2009 and January 2013 in which 896 Roux-en-Y gastric bypasses were performed to treat obesity. The study compared three groups of patients according to the perioperative antibiotic prophylaxis administered intravenously and beginning at anesthesia induction: Group I consisting of 194 patients treated with two 3-g doses of ampicillin/sulbactam; Group II with 303 patients treated with a single 1-g dose of ertapenem; and Group III with 399 patients treated with a 2-g dose of cefazolin at anesthesia induction followed by a continuous infusion of cefazolin 1g throughout the surgical procedure. The rate of surgical site infection was analyzed, as well as its association with age, sex, preoperative weight, body mass index and comorbidities. Results The rates of surgical site infection were 4.16% in the group treated prophylactically with ampicillin/sulbactam, 1.98% in the ertapenem group and 1.55% in the continuous cefazolin group. Conclusion The prophylactic use of continuous cefazolin in surgeries for morbid obesity shows very promising results. These findings suggest that some prophylactic regimens need to be reconsidered and even substituted by more effective therapies for the prevention of surgical site infections in bariatric patients.

Download Full-text