A study of preoperative, intra-operative and postoperative factors responsible for postoperative wound infection

Shobha S. Nisale; Meghraj Chawada; Ganesh K. Kharkate; Sudhir B. Deshmukh

doi:10.18203/2349-2902.isj20171541

Authors

Shobha S. Nisale Associate Professor, Department of General Surgery, SRTR Rural Government Medical College, Ambejogai, Beed, Maharashtra State, India
Meghraj Chawada Associate Professor, Department of General Surgery, SRTR Rural Government Medical College, Ambejogai, Beed, Maharashtra State, India
Ganesh K. Kharkate Third year PG Student, Department of General Surgery, SRTR Rural Government Medical College, Ambejogai, Beed, Maharashtra State, India
Sudhir B. Deshmukh Professor and HOD, Department of General Surgery, SRTR Rural Government Medical College, Ambejogai, Beed, Maharashtra State, India

DOI:

https://doi.org/10.18203/2349-2902.isj20171541

Keywords:

Diabetes mellitus, Length of preoperative stay, Postoperative wound infection

Abstract

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.

Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.

Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.

Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

Metrics

Metrics Loading ...

References

National Academy of Sciences-National Research Council. Ad Hoc Committee of the Committee on trauma, Division of Medical Sciences. Postoperative Wound Infections: The influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg. 1964;160(2):1-192.

Davidson AIG, Clark C, Smith G. Postoperative wound infection: a commuter analysis. Br J Surg. 1971;58:333-6.

Edwards LD. The epidemiology of 2056 remote site infections and 1966 surgical wound infections occurring in 1865 patients. Ann Surg. 1976;184:758-66.

Horan TC, Gaynes RP, Martone WJ. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control. 1992;20:271-4.

Kirkland KB, Briggs JP, Trivette SL. The impact of surgical- site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725-30.

National Nosocomial Infections Surveillance (NNIS) System. NNIS report, data summary from October 1986-April 1996, issued May 1996. A report from the NNIS System. Am J Infect Control. 1996;24(5):380-8.

National Nosocomial Infections Surveillance (NNIS) System. NNIS report, data summary from January 1992 to June 2002, issued August 2002. Am J Infect Control. 2002;30(8):458-75.

Leaper DJ. Wound infection. In: Russell RCG, William NS, Bulstrode CJK, eds. Bailey & Love’s Short Practice of Surgery; 24th ed. London: Arnold; 2004:118-132.

Nicholas RL. Wound infection rates following clean operative procedures: Can assume them below? (Editorial). Infect Cont Hosp Epidemiol. 1992;13:455.

Pea F, Viale P, Furlaunt MI. Antimicrobial agents in elective surgery: Prophylaxis or early therapy? J Chemotherap. 2003;15(1):3-11.

Perl TM, Cullen JJ, Pfaller MA. The MARS study team. A randomized, double-blind, placebo-controlled clinical trial of intranasal mupirocin ointment (IM) for prevention of S. aureus surgical site infections (SSI) [abstract]. Abstracts of the IDSA 36th Annual Meeting. 1998;91(88).

Scott JD, Forrest A, Feuerstein S. Factors associated with post-operative infections. Infect. Control Hosp Epidemiol. 2001;22(6):347-51.

Michalopoulos A, Sparos L. Post-operative wound infection. Nurs Stand. 2003;17(44):53-6.

Umesh SK, Fereirra AMA, Kulkarni MS. A prospective study of surgical site infection in a teaching hospital in Goa. Indian J Surg. 2008;70(3):120-4.

Eltahawy AT, Mokhtar AA, Khalaf RM. Postoperative wound infection at a University hospital in Jeddah, Saudi Arabia. J Hasp Infect. 1992;21:79-83.

Masood A, Shams NA, Obaidullah K. Post-operative wound Infection: A Surgeon’s Dilemma. Pak J Surg. 2007;23(1):41-7.

Suchitra JB, Lakshmidevi N. Surgical site infections: Assessing risk factors, outcomes and antimicrobial sensitivity patterns. African J Microbiol Res. 2009;4:175-9.