Evaluation of Surgical Site Infection in Abdominal Surgeries in Adults

Abstract

Surgical site infections (SSIs) are infections of the incision or organ or space that occur after surgery. The term ‘surgical site infection’ (SSI) was introduced in 1992 to replace the previous term ‘surgical wound infection’. Surgical site infection (SSI) has always been a major complication of surgery and trauma and has been documented for 4000–5000 years. SSI is both the most frequently studied and the leading HAI reported hospital-wide in LMICs. World Health Organization (WHO) Clean Care is Safer Care programme shows that surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure in LMICs and the pooled incidence of SSI was 11.8 per 100 surgical patients undergoing the procedure (range 1.2 to 23.6). Although SSI incidence is much lower in high-income countries, it remains the second most frequent type of HAI in Europe and the United States of America (USA). In some European countries, it even represents the most frequent type of HAI. SSIs are among the most preventable HAIs, but they still represent a significant burden in terms of patient morbidity and mortality and additional costs to health systems and service payers worldwide. Each SSI is associated with approximately 7-10 additional postoperative hospital days and patients with an SSI have a 2-11 times higher risk of death, compared with operative patients without an SSI. Surgical patients initially seen with more complex co morbidities and the emergence of antimicrobial-resistant pathogens increase the cost and challenge of treating SSIs. For these reasons, the prevention of SSI has received considerable attention from surgeons and infection control professionals, health care authorities, the media and the public. Our study prompts us to look at the gaps in our surgical and infection control protocols which will enable policy formulation that will foster a reduction in wound infection rate. SSI can be reduced by decreasing the preoperative hospital stay, appropriate antibiotic administration policies, adequate preoperative patient preparation, reducing the duration of surgery to minimum, judicious use of drains and intraoperative maintenance of asepsis and following operation theatre discipline properly. Although surgical site infections cannot be completely eliminated, a reduction in the infection rate to a minimal level could have significant benefits, by reducing postoperative morbidity and mortality, and wastage of health care resources

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