DOI: http://dx.doi.org/10.18203/2349-2902.isj20183211

Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

Prashanta Swami Pujar, K. B. Phuleker, Nagaraj Bhalki

Abstract


Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.

Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.

Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.

Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.


Keywords


Navodaya Medical College Hospital and Research Centre, Raichur, Risk factors, Surgical site infections

Full Text:

PDF

References


Kumar A, Rai A. Prevalence of surgical site infection in general surgery in a tertiary care centre in India. Int Surg J. 2017;4(9):3101-6.

WHO's Global Guidelines for Prevention of Surgical Site infections provide recommendations for the care of patients before, during and after surgery. (cited 2018 June 1); Available at www.who.int/gpsc/ssi-guidelines/en.

Spagnolo AM, Ottria G, Amicizia D, Perdelli F, Cristina ML. Operating theatre quality and prevention of surgical site infections. J Prev Med Hyg. 2013;54(3):131-7.

Solomkin J. Perioperative antimicrobial prophylaxis and treatment of surgical infection. In: Fischer JE(Eds). Fischer’s Mastery of Surgery. 6th edition. New Delhi: Wolters Kluwer India Pvt Ltd. 2015.117.

Lamont P. Surgical infection. In: Williams NS, O’Connell PR, McCaskie AW(Eds). Bailley and Love’s Short Practice of Surgery. 27th edition. Boca Raton, FL: Taylor and Francis Group. 2018.45-46.

Setty NH, Nagaraja MS, Nagappa DH, Giriyaiah CS, Gowda NR, Laxmipathy Naik RD. A study on Surgical Site Infections (SSI) and associated factors in a government tertiary care teaching hospital in Mysore, Karnataka. Int J Med Public Health. 2014;4(2):171-5.

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. Natl J Commun Med. 2012;3(2):193-6.

Singh S, Chakravarthy M, Rosenthal VD, Myatra SN, Dwivedy A, Bagasrawala I, et al. Surgical site infection rates in 6 cities of India: findings of the International Nosocomial Infection Control Consortium (INICC). 2014:1-6. Available at http://inthealth.oxfordjournals.org/

Fan Y, Wei Z, Wang W, Tan L, Jiang H, Tian L, et al. The incidence and distribution of surgical site infection in mainland China: a meta-analysis of 84 prospective observational studies. Sci Rep. 2014;4:6783.

Shahane V, Bhawal S, Upendra Lele U, Padmashree DY. Surgical site infections: a one year prospective study in a tertiary care center. Int J Health Sci Res. 2012;6(1).79-84.

Akhter MS, Verma R, Madhukar KP, Vaishampayan AR and Unadkat PC. Incidence of surgical site infection in postoperative patients at a tertiary care centre in India. J Wound Care 2016;25(4): 210-2, 214-7.

Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, Kyaw MH. A systematic review of risk factors associated with surgical site infections among surgical patients. PloS one. 2013;8(12):e83743.