Incidence and determinants of the surgical site infection:a hospital based longitudinal study


  • Pinakin K. Sutariya Department of Surgery, GMERS Medical College, Sola, Ahmedabad, Gujarat, India
  • Mallika V. Chavada Department of Community Medicine, GMERS Medical College, Gandhinagar, Gujarat, India



Infection rate, Risk factors, SSI


Background: Surgical site infection (SSI) is one of the common nosocomial infections and associated with increased length of hospital stay, hospital cost, patient morbidity and mortality.

Methods: A prospective longitudinal study was conducted at a tertiary care centre of Ahmadabad city. Total 480 patients operated for general surgical procedures between the periods of January 2016 to June 2016 were included for the present study. Data were collected from the data sheet which included basic demographic detail of the patient, diagnostic criteria and associated risk factors. Data entry and analysis was done in software Epi info version 7.0. Chi square was used to identify association of the risk factor with outcome.  P-value <0.05 was considered to be statistically significant.

Results: In present study, 9.4% of the patients had SSI. The risk factors associated with SSI were age (18.3% versus 7.1%), diabetes (25.5% versus 7.6%), type of anaesthesia (general = 13.6% versus regional=7.1%), type of surgery (emergency = 21.7% versus elective = 7.3%), duration of surgery (17.9% versus 7.2%), type of wound (dirty  = 28.4% versus clean = 2.99%), pre-operative hospital stay (27.3% versus 3.3%) and presence of drain (15.2% versus 7.2%).

Conclusions: Our study emphasizes that age, type of surgery and wound, preoperative hospital stay, co-morbidity and drain   have definite correlation with SSI. A standard infection surveillance protocol needs to be practiced stringently in an attempt to reduce the SSI rate.


Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005;23(4):249-52.

Wong ES. Surgical site infections. In: Mayhall CG, editor. Hospital epidemiology and infection control. 1st ed. U.S.A: Williams and Wilkins; 1996:154-74.

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

Gastmeier P, Brandt C, Sohr D, Rüden H. Responsibility of surgeons for surgical site infections. Chirurg. 2006;77(6):506-11.

Manian FA. The role of postoperative factors in surgical site infections: time to take notice. Clin Infect Dis. 2014;59:1272-6.

Leaper DJ, Goor HV, Reilly J, Berger A. Surgical site infection - a European perspective of incidence and economic burden. 2004;1(4):247-73.

Satyanarayana V, Prashanth HV, Bhandare B, Kavyashree AN. Surgical site infection in abdominal surgeries. J Clin Diagn Res. 2011;5(5):935-9.

Center for disease control, National nosocomial infections study quarterly report, first and second quarters. Altlanta, CDC; 1973.

Jelliffee BD. The assessment of the nutritional status of the community. Geneva: WHO. 1966;53:63-78.

Park K. Text Book of Preventive and Social Medicine. 20th ed. M/s Banarsidas Bhanot Publisher; 2009.

Bibi S, Channa GA, Siddiqui TR, Ahmed W. Frequency and risk factors of surgical site infections in general surgery ward of a tertiary care hospital of Karachi, Pakistan. International J Infect Cont. 2011;1;7(3):1-5.

Surgical site infection and antibiotics use pattern in a tertiary care hospital in Nepal. P Pak Med Assoc. 2008;58(3):148-51.

Patel SM, Patel MH, Patel SD, Soni ST, Kinariwala DM, Vegad MM. Surgical site infections: incidence and risk factors in a tertiary care hospital, Western India. National J Com Med. 2012;3(2).

Kamat US, Fereirra AM, Kulkarni MS, Motghare DD. A prospective study of surgical site infections in a teaching hospital in Goa. Indian Journal of Surgery. 2008;70(3):120-4.

Schwartz SI, Comshires G, Spencer FC, Dally GN, Fischer J, Galloway AC. Principles of surgery. NY: McGraw-Hill companies; 1999:83-7.

Razavi SM, Ibrahimpoor M, Kashani AS, Jafarian A. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital. BMC Surgery. 2005;5(1):1.

Maksimovic J, Denic LM, Bumbasirevic M. Surgical site infections in orthopedic patients: prospective cohort study. Croat Med J. 2008;49:58-65.

Waisbren E, Rosen H, Bader AM. Percentzection. J American Col Surg. 2010;210(4):381-9.

Khairy GA, Kambal AM, Al Dohayan AA. Surgical site infection in a teaching hospital: a prospective study. J Taibah University Medical Sciences. 2011;31;6(2):114-20.

Shahane VD, Bhawal S, Lele U. Surgical site infections: a one year prospective study in a tertiary care center. International J Health Sci. 2012;23;6(1).

Berard F, Gandon J. Factors influencing the incidence of wound infection. Ann Surg. 1964;160:32-81.

Tripathy BS, Roy N. Post - operative wound sepsis. Indian. J sur. 1984;285-8.

Couris CM, Rabilloud M, Ecochard R, Metzger MH, Caillat-Vallet E, Savey A, et al. Nine-year downward trends in surgical site infection rate in southeast France (1995-2003). J Hosp Infect. 2007;67:127-34.

Ward VP, Charlett A, Fagah J, Crawshaw SC. Enhanced surgical site infection surveillance following caesarean section: experience of a multicenter collaborative post-discharge system. J Hosp Infect. 2008;70:166-73.

Malik ZI, Nawaz T, Abdullah MT, Waqar SH, Zahid MA. Surgical site infections in general surgical wards at a tertiary care hospital. Pakistan J Med Res. 2013;1:52(4):116.






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