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Surgical site infection in clean surgeries: role of risk factors

Author: 
Dr. Anjali Swami, Dr. Saiprasad Patil, Dr. Badhuli Samal and Dr. Jayanthi Shastri
Subject Area: 
Health Sciences
Abstract: 

Background: Surgical site infection (SSI) is a potentially preventable complication. The aim of this study was to detect the incidence of surgical site infection in clean surgeries, risk factors involved, and organisms isolated. Study design: From June 2009 to January 2010, patients admitted for surgery under General, Orthopedic, and Cardiovascular surgery departments in a tertiary care Hospital were included in the study. The exclusion criteria included, age less than 18 years and more than 80 yrs. The parameter studied were age, sex, presence of diabetes, congestive heart failure, chemotherapy, tobacco use, remote site infection, length of preoperative stay, antimicrobial prophylaxis and duration of surgery. Appropriate sample from suspected sites of infection were cultured and antimicrobial susceptibility of cultured organism was tested. Patients were followed up after discharge telephonically. Results: Two hundred and seventy patients were studied. Of these 10(3.7%) developed SSI. The cases were Mastectomy (11.11%), Inguinal hernia (7.24%), Hip replacement (4.76%), Laminectomy (4.34%),CABG (3.33%). Organisms isolated were Staphylococcus aureus (4), CoNS (2), E.coli (2), Pseudomonas sp. (2). Preoperative hospital stay was associated with significantly higher infection rate (p-0.001). Underlying chemotherapy, diabetes, remote infection, duration of surgery were associated with increased risk of surgical site infection. Discussion: Preoperative hospital stay was found to be the most important factor leading to surgical site infection. Diabetes, chemotherapy, congestive heart failure, duration of surgery, though not statistically significant, appeared to be important. Half of the isolates were multiresistant strains, they could be hospital acquired. Preoperative “Higher” antibiotics do not lower postoperative infection rate.

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