A Prospective Observational Study of Surgical Site Infections in Clean and Clean Contaminated Surgeries in a Tertiary Care Hospital

Abstract

Introduction: Surgical Site Infections [SSIs] have plagued surgeons since time immemorial. Infection is encountered by all the surgeons; by nature of their craft, they invariably impair the first line of host defences, the cutaneous or the mucosal barrier. The entrance of microbes into the host tissues is the initial requirement for infection.

Materials and methods: This was a prospective observational study conducted in a tertiary care hospital over a period of one year from September 2023 to August 2024 at Department of General surgery, ACSR Govt Medical College, Nellore, AP. Universal sampling was employed for the study duration.

Results: Total 4764 clean and clean contaminated surgeries were included in the study. Out of these 98 patients developed SSI. The incidence of SSI was 2.05%. There were 2596 (54.50%) male patients, out of which 18 (0.69%) developed SSI. While out of 2168 (45.50%) female patients 80 (3.70%) developed SSI. The age of the patients in the study ranged from 18 years to 75 years. Out of 98 patients who developed SSI, 42 were in the age group of 21-30, 26 were between the age group of 31-40, 16 were between the age group of 41-50, 8 were between the age group of 51 to 60 and 6 patients were above 60 years of age. The incidence of SSI in planned surgery was 1.64%, while the incidence in emergency surgery was 3.08%.

Conclusion: In our study association of the type of surgery, age and gender with SSI was observed. Due to SSI, post-operative stay in the hospital was increased. With good surveillance system we could diagnose SSI cases even after the discharge from the hospital. Regular surveillance of SSI with feedback of appropriate data to the stakeholders is desirable to reduce SSI rate. Post discharge surveillance of SSI is challenging and it should be addressed by infection control team for accurate mapping of SSI.