A Clinical Study of Surgical Site Infections in a Tertiary care Hospital

Year : 2019 | Volume : 7 | Issue : 1 Page : 35-39

L Srinivas¹,A Sudhamshu Reddy²,Samir Ahmad³

¹Assistant Professor,²Final year Post Graduate,³Second year Post Graduate, Department of General Surgery, Prathima Institute of Medical Sciences, Karimnagar, Telangana.

Address for correspondence: : Dr L.Srinivas, Assistant Professor , Department of General Surgery, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India.

Email: srinivas.mbbs.ms@gmail.com

Abstract

Introduction: Surgical infections are those that occur as a result of a surgical procedure or those that require surgical intervention as part of their treatment. They are characterized by a breach of mechanical/anatomic defense mechanisms (barriers) and are associated with greater morbidity, significant mortality, and increased cost of care.

Aims and Objectives: The present study was done to know the incidence of surgical site infections in our medical college, to study the risk factors associated with the surgical site infections and to find out the Most common organism encountered and its antibiotic sensitivity and resistance in surgical site infection (SSI).

Materials and Methods :Patients who underwent various surgeries at Prathima Institute of Medical Sciences, in between 1st January 2016 to 31st March 2017 are considered for this study. The total number of cases studied is 400. This is a prospective study.

Results:Incidence of surgical site infection in this study is 9.75%. Majority of patients in the study belong to age group of 21-30 years which account for 28.5%. Elective had an incidence of 5% and emergency cases had more incidences of 24%. Most of the cases had SSI detected on 3rd post-operative day. Anemia was found to be the main risk factor with more number of SSI’s. Infection rate was found to be increasing as the number of pre- op hospitalisation increased. Prophylactic antibiotic therapy was found to decrease the rate of SSI’s. Longer duration of surgery and use of drain was associated with increased rate of SSI. As expected the rate of infection increased from clean wounds to contaminated wounds. E- coli was the commonest organism isolated. Most of the organisms were isolated from the clean contaminated and contaminated cases. Overall imepenem and amikacin were the most sensitive antibiotics.

Conclusion:A pre-existing medical illness, prolonged operating time, the wound class, emergency surgeries and wound contamination strongly predispose to surgical site infection. Antimicrobial prophylaxis is effective in reducing the incidence of post- operative wound infections for a number of different operative procedures but, timing of administration is critical. Reduction of length of procedures through adequate training of the staff on proper surgical techniques, proper intra-operative infection control measures and feedback of appropriate data to surgeons regarding SSIs would be desirable to reduce the surgical site infection rate.

Keywords:Surgical Site Infection, Wound, Contamination, Infection, Antibiotics