Surgical site infection in patients undergoing urgent abdominal surgery

Abstract

Background : Surgical site infection (SSI), is a major problem and the most common complication of surgery. It was considered an essential indicator for a quality of care of hospital. SSI affects patients suffer from increasing morbidity and mortality, prolongs length of stay, delay recovery, decreases quality of life, and increases medical costs. Although urgent abdominal surgery is a significant treatment for patients with life-threatening intraabdominal conditions, it is usually associated with increased risk of SSI. Factors related to SSI need to be explored to help improve healthcare services and surveillance program in high-risk patients.

Objective : To study SSI incidence and the factors associated with SSI in patients undergoing urgent abdominal surgery.

Designs : Descriptive retrospective research design.

Setting : King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Material and Method : The data was collected from the medical record. The collected data: age, hospital length of stay, kind of surgical procedure, the duration of surgery, comorbidity, the American Society of Anesthesiologists physical status (ASA), Obesity, preoperative and postoperative Systemic Inflammatory Response Syndrome (SIRS), type of surgical wound (clean, clean-contaminate, contaminate and dirty), blood transfusion, admission to intensive care unit (ICU) after surgery, plasma glucose level, serum albumin level and prophylactic antibiotic. Inclusion criteria comprised patients who were > 16 years old and had urgent abdominal surgery at King Chulalongkorn Memorial Hospital from January 1, 2010, to December 31, 2012. Data was analyzed by using SPSS V.11.5. The relationships were tested by Chi-square, the Fisher exact test and the Odd Ratio was tested by Cochran’s and Mantel-Haenzed.

Result : Of 439 patients undergoing urgent abdominal surgery, 93 (21.18%) developed SSI and factors were associated with SSI (P < .05) in patients undergoing urgen tab dominal surgery, were the American Society of Anesthesiologists physical status (ASA) and preoperative Systemic Inflammatory Response Syndrome (SIRS), the duration of surgery, the type of wound, the use of drainage, blood transfusion, the admission to ICU after surgery, postoperative plasma glucose levels, serum albumin levels, postoperative Systemic Inflammatory Response Syndrome(SIRS) and prophylactic antibiotics.

Conclusion : SSI remains a major problem and the most common complication of surgery, factors related to SSI compare with other study, there is different for some factors. The using result of study to monitor risk factors and to develop the surveillance program in patient with undergoing urgent abdominal surgery, these can improve patients care services.