Details
Category: Volume 07 Issue 03 March 2019
Hits: 1365

Title: A Study on Surgical Site Infections in Abdominal surgeries

Authors: Dr A.Kalyani, Dr A Saikiran, Dr SK.Khalifa, Dr V.Koteswararao, Dr P.Santhi Sree

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.19

Abstract

Background: Surgical site infection (SSI) is the most commonly reported nosocomial infection. Surgical site infections are responsible for increase in cost, morbidity, and mortality related to surgical operations.  Surveillance with information feedback to surgeons and other medical staff has been shown to be an important element in the overall strategy to reduce the numbers of Surgical site infections (SSI). This study aims to study the prevalence of SSI in the Department of Surgery, Andhra medical college, Visakhapatnam

Aims and objectives of the study: To determine the incidence and types of surgical site infections (SSIs) following abdominal surgeries

Materials and Methods: A retrospective study was undertaken on patients admitted to general surgery units at the, Department of General Surgery, Andhra medical college, King George Hospital, Visakhapatnam. The study period in this super specialty teaching institution was one year. A total of 553elective surgical patients and 314 emergency surgical patients were included in the study.

Results: The present study revealed 10.5% prevalence of SSI in department of general surgery, Andhra medical college. Vishakapatnam. Among the 3 types, superficial incision SSI was most prevalent followed by deep incisional SSI and finally by organ/space SSI. The surgical procedure most commonly associated with SSI was exploratory laparotomy. An alarming 19.42% of SSI was associated with emergency surgeries as compared to 7.05% of elective surgeries.

Conclusion: The consequences of SSIs greatly impact patients and the healthcare systems. Prevention of SSI requires a multifaceted approach targeting pre-, intra-, and postoperative factors. It is imperative that facilities have open-minded management teams, regulatory agencies and medical associations that want to provide the foundation required to generate a culture of patient safety in our health care systems

Keywords: General surgery, Nosocomial infection, SSI, Surgical site infection, Surgery.

References

  1. Apte A, Jain A, Singh Y, Modi H. A PROSPECTIVE STUDY TO ASSESS RISK FACTORS FOR SURGICAL SITE INFECTIONS IN A TERTIARY CARE CENTER. Journal of Evolution of Medical and Dental Sciences.;1(4):3404-11.
  2. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. American journal of infection control. 1999 Apr 30;27(2):97-134.
  3. Borse H, Shelke R. Study of Various Organisms Associated with Surgical Site Infection and their Sensitivity Pattern. MVP Journal of Medical Science. 2015 Dec 1;2(2):118-23.
  4. Richard T, Ethridge, Mimi Leon and Linda G. Philips: “wound healing”. Sabiston Text book of Surgery, 18th edition, p 191-216.
  5. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol1992;13:606–8.
  6. Moossa AR, Hart ME, Easter DW, Sabiston DC, Lyerly HK. Surgical complications. Textbook of surgery: the biological basis of modern surgical practice. 15th ed. Philadelphia: WE Saunders. 1997:341-59.
  7. Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, Foley EF. Wound infection after elective colorectal resection. Annals of surgery. 2004 May 1;239(5):599-607.
  8. Leung JM, Dzankic S. Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients. Journal of the American Geriatrics Society. 2001 Aug 1;49(8):1080-5.
  9. Buzby GP, Williford WO, Peterson OL, Crosby LO, Page CP, Reinhardt GF, Mullen JL. A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. The American journal of clinical nutrition. 1988 Feb 1;47(2):357-65.
  10. Nyström PO, Jonstam A, Höjer H, Ling L. Incisional infection after colorectal surgery in obese patients. Acta chirurgica scandinavica. 1987 Mar;153(3):225-7.
  11. Stulberg JJ, Delaney CP, Neuhauser DV, Aron DC, Fu P, Koroukian SM. Adherence to surgical care improvement project measures and the association with postoperative infections. Jama. 2010 Jun 23;303(24):2479-85.
  12. Ingraham AM, Cohen ME, Bilimoria KY, Dimick JB, Richards KE, Raval MV, Fleisher LA, Hall BL, Ko CY. Association of surgical care improvement project infection-related process measure compliance with risk-adjusted outcomes: implications for quality measurement. Journal of the American College of Surgeons. 2010 Dec 31;211(6):705-14.
  13. Bratzler DW, Houck PM, Richards C, Steele L, Dellinger EP, Fry DE, Wright C, Ma A, Carr K, Red L. Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Archives of Surgery. 2005 Feb 1;140(2):174-
  14. Dale WB, Peter MH, Surgical Infection Prevention Guidelines Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clinical Infectious Diseases. 2004 Jun 15;38(12):1706-15.
  15. Dellinger EP, Hausmann SM, Bratzler DW, Johnson RM, Daniel DM, Bunt KM, Baumgardner GA, Sugarman JR. Hospitals collaborate to decrease surgical site infections. The American Journal of Surgery. 2005 Jul 31;190(1):9-15.
  16. Berard F, Gandon J. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Annals of surgery. 1964 Aug;160(Suppl 2):1.
  17. Ayliffe GA. Role of the environment of the operating suite in surgical wound infection. Review of Infectious Diseases. 1991 Sep 1;13(Supplement 10):S800-4.
  18. Hingst V, Juditzki I, Heeg P, Sonntag HG. Evaluation of the efficacy of surgical hand disinfection following a reduced application time of 3 instead of 5 min. Journal of Hospital Infection. 1992 Feb 1;20(2):79-86.
  19. Platell C, Papadimitriou JM, Hall JC. The influence of lavage on peritonitis. Journal of the American College of Surgeons. 2000 Dec 31;191(6):672-80.
  20. Cervantes-Sánchez CR, Gutiérrez-Vega R, Vázquez-Carpizo JA, Athié-Gutiérrez C. Syringe pressure irrigation of subdermic tissue after appendectomy to decrease the incidence of postoperative wound infection. World journal of surgery. 2000 Jan 1;24(1):38-42.
  21. Mishriki SF, Law DJ, Jeffery PJ. Factors affecting the incidence of postoperative wound infection. Journal of Hospital Infection. 1990 Oct 1;16(3):223-30.
  22. Gil-Egea MJ, Pi-Sunyer MT, Verdaguer A, Sanz F, Sitges-Serra A, Eleizegui LT. Surgical wound infections: prospective study of 4,468 clean wounds. Infection Control. 1987 Jul 1;8(07):277-80.
  23. Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-June 2001, issued August 2001. Am. J. Infect. Control. 2001;29:404-21.

Corresponding Author

Dr A.Kalyani

Associate Professor, Department of General surgery, King George Hospital, Andhra Medical College, Visakhapatnam, India