Incidence and risk factors of surgical site infections in elective abdominal surgeries

AIM OF THE STUDY: 1. Incidence of abdominal surgical site infection. 2. Risk factors for abdominal surgical site infection. 3. To study most common organism encountered and their sensitivity to antibiotics. MATERIALS AND METHODS: Period of Study: Data was collected prospectively from December 2013 to September 2014. Place of Study: Government Kilpauk Medical College Hospital and Government Royapettah Hospital. INCLUSION CRITERIA: 1. Only those patients who have undergone elective abdominal surgeries in Govt. Kilpauk Hospital and Govt. Royapettah Hospital were included. 2. Age of the patient more than 12 years. 3. Patients presenting with following signs at the surgical site: Erythema, Induration, Discharge—serous/purulent, Wound gaping. EXCLUSION CRITERIA: 1. Patients who undergo emergency abdominal surgery. 2. Age less than 12 years. 3. HIV positive state and patients on steroid. SIZE OF THE STUDY: 150 patients. TYPE OF STUDY: prospective observational study. SOURCE OF DATA: The source of data for my study were the patients who underwent abdominal surgeries in the Department of General Surgery at Govt. Kilpauk Medical College Hospital and Govt. Royapettah Hospital. In my study, I took into account, the pre operative risk factors such as obesity, hypertension,diabetes and intra operative risk factors duration of surgery, diathermy usage of the patient and post operatively, I looked into signs of wound infection. I sent discharges for culture and sensitivity and started appropriate antibiotics. DISCUSSION: 1. SSI – INCIDENCE: Among the 150 patients taken for my study, surgical site infection was present in 130 patients (86.7%) which is very much higher than17.4% and 16%which was noted in other studies. 2. SSI– SEX: SSI is not correlated with gender. this finding is similar to that in other studies andliterature. 3. SSI – AGE: The age increases the incidence of surgical site infection increases (p value < 0.05). 4. SSI- COMORBIDS: The incidence of surgical site infection is high among obese patients than others and other risk factors have no significance with surgical site infection, though diabetes mellitus and hypertension are established risk factors in surgical site infection. 5. SSI - DURATION OF SURGERY: There is no significant relation between surgical site infection and duration of surgery. but significance has been noted in other studies. 6. SSI-DURATION OF DIATHERMY USAGE --in my study there is no significant relation between surgical site infection and duration of diathermy usage. 7. The most frequent presentation of surgical site infection is induration. CONCLUSION: The incidence of SSI in my study is 86.7%, which is very much higher. Though several risk factors have an effect on surgical site infection, my study provides a positive correlation of SSI with obesity only. The most common organism encountered in my study is Escherichia coli and the most sensitive antibiotic is Ciprofloxacin. Thus surgical site infection has a burden on economy of the society and its incidence should be brought down by a multimodal approach