Surgical Site Infection Following Elective and Emergency Surgical Procedures

Amna Farid, Mazhar Iqbal, Tunza Irfan, Syed Shafqatullah, Resham Ali, Ayesha Mehboob

Abstract

Objective

To determine the frequency of surgical site infection following elective and emergency surgical procedures.

Study design

Cross sectional observational study.

Place & Duration of study

Department of General Surgery Ward II, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from January 2022 to January 2023.

Methods

Patients who underwent any surgical procedures, both as elective cases or in emergency, were included. Postoperatively patients were followed in wards and after discharge in outpatient department on 5th, 7th and 30th day. The wounds were assessed for the development of surgical site infection. In infected wounds the purulent discharge was sent for culture and sensitivity. Data were collected and analysed using SPSS version 23. Descriptive statistics were used for presenting quantitative and qualitative variables. A 95% confidence interval was calculated for each proportion and tested by one sample t test.

Results

Total of 903 patients were operated. This included 663 elective and 240 emergency cases. On elective operation list 392 (59.12%) female and 271(40.88%) male patients were operated while in emergency settings 184 (76.67%) male and 56 (23.33%) female underwent surgery. The surgical site infection in emergency operations noted in 156 (65%) and in elective operations in 32 (4.82%) patients. The wound infection was most commonly noted in patients who had peritonitis (n=126). This was found statistically significant [(n=122 - 96.82%)  p=0.001]. In emergency cases the rate of mild infection was 42.30%, moderate 24.35% and severe 47.4%. In elective cases mild wound infection rate was 60%, moderate 29% and severe 10.5%.

Conclusion

The infection rate was very high in emergency cases especially in patients who presented with peritonitis. It was low in intestinal obstruction and trauma cases. Overall infection rate in elective cases was less than 5%.

Key words

Surgical site infection, Emergency surgery, Elective surgery, Wound infection, Peritonitis.