scholarly journals Outcome of Surgical Site Infection in General Surgical Practice in a District Hospital

2021 ◽  
Vol 39 (3) ◽  
pp. 171-177
Author(s):  
Ashrafur Rahman ◽  
Fahmida Sharmin Joty
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
District Hospital ◽  
Significant Risk ◽  
Site Infection ◽  
Surgical Practice ◽  
Peripheral Hospital ◽  
Duration Of Surgery ◽  
Type Of Surgery

Background: Surgical site infection (SSI) can affect the surgical procedures in the peripheral hospital adversely and adequate data can help in the management of this unwanted complication. Aim & Objective: The study was conducted with the aim to identify the outcome of surgical site infection (SSI) in a secondary level district hospital. Materials & Methods: A total of 192 patients, underwent general surgical procedures in the 100-bedded district hospital, Shariatpur, Bangladesh from January to December, 2016. All were observed for development of SSI for a period of 30 days after their surgical procedure. SSI cases were identified according to National Healthcare Safety Network (CDC/NHSN) guideline and Southampton wound scoring system. Univariate and multivariate analysis was done to identify significant risk factors for development of SSI. Results: Overall incidence of SSI was 20.31%. Significant risk factors for development of SSI were age, BMI, ASA grade, wound classification, diabetes, type of surgery, duration of surgery and perioperative transfusion (p<0.05). Among them, BMI (OR=1.434), diabetes (OR=8.126), type of surgery (routine/emergency) (OR=6.097), duration of surgery (OR=1.023) and perioperative transfusion (OR=2.130) were determined as independent risk factors on logistic regression. Conclusion: SSI has a relatively high incidence in rural surgical practice. Identification and control of predictable risk factors would help to reduce the incidence of SSI. J Bangladesh Coll Phys Surg 2021; 39(3): 171-177

scholarly journals Incidence and Risk Factors of Recipient Surgical Site Infection in Oral and Maxillofacial Reconstruction with Vascularized Fibular Bone Grafts

2020 ◽  
pp. 231
Author(s):  
Pichai Vittayakittipong ◽  
Sarocha Makmanee
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Significant Risk ◽  
Bone Grafts ◽  
Class Ii ◽  
P Value ◽  
Site Infection ◽  
Physical Status ◽  
Recipient Site ◽  
Maxillofacial Reconstruction

Objective: To determine the incidence and risk factors of recipient surgical site infection (RSSI) after oral and maxillofacial reconstruction with vascularized fibular bone grafts (VFBG).Material and Methods: This retrospective study was performed in patients who underwent oral and maxillofacial reconstructive surgery, with VFBG, at the Dental Hospital, Faculty of Dentistry, Prince of Songkla University. Demographic, preoperative, intraoperative and postoperative data were recorded. Any infection at the recipient site occurring within 30 days post-operatively, by criteria from the Center of Disease Control, was defined as RSSI. Statistical analysis was performed by chi-square test, Student's t-test and Pearson’s correlation coefficient with statistical significance was set at 0.05.Results: There were twenty-one patients who met the eligibility criteria. The incidence of RSSI after oral and maxillofacial reconstruction with VFBG was 47.6% (10/21 patients), and the success rate of VFBG was 95.2%. American Society of Anesthetics (ASA) physical status class II and oral contamination were significant risk factors for RSSI (p-value=0.004 and p-value=0.031, respectively). Length of hospital stay was significantly higher in the RSSI group (p-value<0.001).Conclusion: The incidence of RSSI after oral and maxillofacial reconstruction with VFBG was high, and ASA physical status class II and oral contamination were significant risk factors for RSSI.

scholarly journals Assessment of risk factors for surgical site infection following caesarean section

2019 ◽  
Vol 8 (11) ◽  
pp. 4518
Author(s):  
Aditi Sangwan ◽  
Vani Malhotra
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Emergency Caesarean ◽  
Group I ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Wound Discharge ◽  
Group Ii

Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus.      Mean duration of resuturing was 17.42±6.98 days.  Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.

scholarly journals Liberal and Restrictive Blood Transfusion Strategies in Orthopedic Surgery: Risk Factors for Surgical Site Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s313-s314
Author(s):  
Hoberdan Pereira ◽  
Marcelo Perucci ◽  
Lucas de Lima ◽  
Daniel Bodour ◽  
Laura Vieira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Blood Transfusions ◽  
Site Infection ◽  
Lower Limb Fractures ◽  
Limb Fractures

Background: The identification of risk factors for infections in surgical patients with lower-limb fractures and blood transfusions has increased in recent years. Surgical site infections (SSIs) increase hospitalization, care costs, and patient suffering. Correction surgery for lower-limb fractures and blood transfusion is quite common between surgical procedures. The aim of this study was to describe the relationship between blood transfusion and SSI in patients undergoing orthopedic surgery on lower limbs. Methods: We conducted a prospective cohort study to identify risk factors for SSI in blood transfused patients undergoing fracture repair in lower-limb surgeries between February 2017 and May 2019 in 2 reference tertiary-care hospitals in Belo Horizonte, a city of 3 million people in Brazil. Data regarding patient characteristics, surgical procedures, blood transfusions, and surgical infections were collected. Patient characterization was performed by calculating the absolute and relative frequencies of categorical variables and calculating mean, median, minimum, maximum, standard deviation, and coefficient of variation for quantitative variables. The incidence of surgical site infection, the risk of postoperative hospital death, and the total length of hospital stay were calculated by point estimates and 95% confidence intervals identified by statistical tests of bilateral hypotheses, considering the level of significance of 5%. A multivariate analysis (logistic regression) was performed to identify SSI risk factors. Results: Patients who had an indication for blood transfusion (n = 38) but who did not receive blood (n = 4) had significantly lower hemoglobin, comparing discharge with admission, than the group who received blood. Intraoperative transfusion was a risk factor for SSI (OR, 4.7) (Fig. 1). Among the 205 patients with no indication for transfusion, 98 received blood even without the indication: there was no difference in hemoglobin outcome when discharge and admission were compared, and the 98 patients were exposed to unnecessary risk. Regarding restrictive versus liberal transfusion strategies, there were differences in the variables, age (P = .000), duration of surgery (P = .003), number of comorbidities (P = .000), body mass index (BMI) (P = .027), previous hemoglobin (P = .000), and high hemoglobin (P = .000), considering the transfusion practice employed (Fig. 2). Conclusions: The indications for and definition of protocols and careful evaluation of blood transfusion are critical to avoid infectious complications in orthopedic patients with lower-limb fractures.Funding: NoneDisclosures: None

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

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

scholarly journals Risk Factors Associated With 55 1 In Elective Gastrointestinal Surgery: A Prospective Study In A Specialized Surgical Centre

2019 ◽  
Vol 16 (2) ◽  
pp. 71-75
Author(s):  
Aminul Islam Joarder ◽  
Mohammad Salahuddin Faruque ◽  
M Nur E Elahi ◽  
Ishrat Jahan ◽  
Omar Siddiqui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Smoking Habit ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Operation Time ◽  
Drain Tube ◽  
Site Infection ◽  
A Prospective Study ◽  
Surgery Department

Background: Understanding SSI and providing feedback to the surgical team has been shown to reduce the incidence of surgical site infection and the cost incurred due to it. Objective: To assess the risk factors of surgical site infection (SSI) in elective gastrointestinal surgery. Methods: prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 0 to July 201 2. All preoperative risk factors were evaluated .Patients operated were followed in the post operative period and if any wound infection noted, swab from the site of infection was sent for culture and sensitivity and antibiotics were given accordingly. Results: The incidence of SSI was 1 83(1 6.31 %).Out of this 1 83 cases 65.6% had BMI <25. Anaemia was present in 45.90% cases, bronchopulomnary disease was present in 1 1 .5% cases and DM & jaundice was present in 8.1 9% and 28.9% cases accordingly. 69(37.7%) cases were habitual smoker.SSI rate progressively increased with rate of contamination and maximum infection occurred in lower GIT surgery which was 144(1 7.84%). SSI developed more, in 1 02 (55.74 %) cases when duration of peration was more th ;1 1 1;1.2 hours. In 73.8% cases of SSI drain tube was used. Statistically significant risk factors for SS were found to be smoking habit, BMI <25, preoperative anaemia and duration of operation more than two hours. Conclusion: Specific optimization of the patients' preoperative condition is essential to reduce the risk of SSI following elective gastrointestinal surgery. Surveillance should be conducted and maintained in all hospitals to promote better surgical outcomes. Cessation of smoking, optimization of nutritional status, correction of anaemia and reduction of operation time should be associated with a lower incidence of SSI. Journal of Surgical Sciences (2012) Vol. 16 (2) : 71-75

scholarly journals Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khaled Gomaa ◽  
Ahmed R. Abdelraheim ◽  
Saad El Gelany ◽  
Eissa M. Khalifa ◽  
Ayman M. Yousef ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
Control Group ◽  
Site Infection ◽  
Incidence Risk

Abstract Background Surgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%. This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital. Methods This was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics. Results The incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%. Conclusions The obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases. Registration Local ethical committee (Registration number: MOBGYN0040).

scholarly journals A prospective study of surgical site infection of orthopedic implant surgeries

2017 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Muhammad Thahir ◽  
Suresh Gandhi ◽  
Kalaivanan Kanniyan ◽  
Ravi Kumar
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Risk Index ◽  
Univariate Analysis ◽  
Cost Of Care ◽  
Orthopaedic Implant ◽  
Site Infection ◽  
Duration Of Surgery

<p class="abstract"><strong>Background:</strong> Surgical-site infection accounts for approximately 10% of all hospital-acquired infections, which are estimated to double the cost of care and result in an additional mean of 6.5 days of hospital stay. We did prospective study of surgical site infection of orthopaedic implant surgeries.</p><p class="abstract"><strong>Methods:</strong> The aim of the study is to assess the clinical and microbiological outcome of 125 patients who had open reduction and internal fixation with implants and prosthesis at Southern Railway Hospital from January 2006 to January 2007, and its strength of association with major risk factors using univariate analysis. In our study, Patients were allocated in to three groups as NINS risk index group 0, 1 and 2 with risk factors as duration of surgery &gt;2 hours and ASA class ≥3. Post-operative wound infection was diagnosed based on the criteria of Center of Disease Control and assessed for the period of 6 weeks using National Nosocomial Infections Surveillance Risk Index.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 87 male and 38 females in the study. From 125 Patients, 13 patients had post-operative superficial surgical site infection and presented within 21 days of operation. The infection rate was 10.4%. Two Patients developed deep infection after 6 weeks of study. All the cases with superficial infection were followed at regular intervals, 11 cases resolved with regular dressing and antibiotics but 2 cases continued to discharge sinus up to 3 months.</p><p><strong>Conclusions:</strong> The study showed that the risk of infection rate increased significantly with ASA score, duration of surgery, obesity and NINS risk index. There was no significant association of infection rate with age, diabetes and smoking. </p>

Risk Factors for Surgical Site Infection in Children

2006 ◽  
Vol 27 (7) ◽  
pp. 709-715 ◽  
Author(s):  
Juan Francisco Casanova ◽  
Rafael Herruzo ◽  
Jesús Díez
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Pediatric Patients ◽  
Risk Index ◽  
Venous Catheter ◽  
University Hospital ◽  
Site Infection ◽  
Convenience Sample ◽  
Peripheral Venous Catheter ◽  
Duration Of Surgery

Objectives.To assess the appropriateness of using the indices developed by the Study on the Efficacy of Nosocomial Infection Control (SENIC) and the National Nosocomial Infections Surveillance (NNIS) project to determine risk factors for surgical site infection (SSI) in children and, if not appropriate, to explore the factors related to SSI in children so these factors could be used in a risk index for pediatric patients.Design.Cohort study during more than 4 years.Setting.La Paz University Hospital, a national reference center that serves Health Area 5 of Madrid, Spain, which has approximately 500,000 inhabitants.Patients.Convenience sample consisting of the 3,646 children admitted for surgery who had a postsurgical stay of more than 2 days.Results.A model with 8 predictive factors (degree of surgical contamination; duration of surgery; type of surgery; use of a peripheral venous catheter, central venous catheter, or urinary catheter; number of diagnoses; and SSI exposition time) was created. Its relation to the SSI rate was better than that of the SENIC or NNIS indices. Its sensitivity, specificity, and area under the receiver–operating characteristic curve were higher than that of the SENIC index.Conclusions.The model that we created seems to be more adequate for predicting SSI and evaluating pediatric patients' intrinsic risk than the SENIC and NNIS indices.

Finding a Method for Optimizing Risk Adjustment When Comparing Surgical-Site Infection Rates

2004 ◽  
Vol 25 (4) ◽  
pp. 313-318 ◽  
Author(s):  
Christian Brandt ◽  
Sonja Hansen ◽  
Dorit Sohr ◽  
Franz Daschner ◽  
Henning Rüden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Surgical Site Infection ◽  
Regression Models ◽  
Predictive Power ◽  
Risk Index ◽  
Significant Risk ◽  
Site Infection ◽  
Logistic Regression Models ◽  
System Risk

AbstractObjective:To investigate whether stratification of the risk of developing a surgical-site infection (SSI) is improved when a logistic regression model is used to weight the risk factors for each procedure category individually instead of the modified NNIS System risk index.Design and Setting:The German Nosocomial Infection Surveillance System, based on NNIS System methodology, has 273 acute care surgical departments participating voluntarily. Data on 9 procedure categories were included (214,271 operations).Methods:For each of the procedure categories, the significant risk factors from the available data (NNIS System risk index variables of ASA score, wound class, duration of operation, and endoscope use, as well as gender and age) were identified by multiple logistic regression analyses with stepwise variable selection. The area under the receiver operating characteristic (ROC) curve resulting from these analyses was used to evaluate the predictive power of logistic regression models.Results:For most procedures, at least two of the three variables contributing to the NNIS System risk index were shown to be independent risk factors (appendectomy, knee arthroscopy, cholecystectomy, colon surgery, herniorrhaphy, hip prosthesis, knee prosthesis, and vascular surgery). The predictive power of logistic regression models (including age and gender, when appropriate) was low (between 0.55 and 0.71) and for most procedures only slightly better than that of the NNIS System risk index.Conclusion:Without the inclusion of additional procedure-specific variables, logistic regression models do not improve the comparison of SSI rates from various hospitals.

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