Surgical Site Infection: Re-assessment of the Risk Factors

Area of Science:

• General Surgery
• Infectious Disease Epidemiology
• Patient Safety

Background:

• Surgical site infection (SSI) is a frequent complication in general surgery and the most common hospital-acquired infection.
• SSIs significantly impact patient outcomes and increase healthcare expenditures.

Purpose of the Study:

• To identify independent risk factors for surgical site infections (SSIs) in general surgery patients.
• To analyze patient demographics, comorbidities, procedural details, and SSI characteristics to understand SSI etiology.

Main Methods:

• A retrospective study included 4690 patients undergoing general surgery between 2003 and 2009.
• Surgical site infections were diagnosed using National Nosocomial Infection Surveillance (NNIS) criteria.
• Multivariate analysis identified independent risk factors associated with SSI development.

Main Results:

• The overall SSI rate was 4.09%, with colorectal surgery having the highest incidence (9.43%).
• Key risk factors identified include specific procedure types (colorectal, hepatobiliary, upper GI, pilonidal sinus), prolonged preoperative stay, higher ASA score, emergency surgery, contaminated wound class, surgeon experience, extended operating time, surgical drains, and intraoperative transfusion.

Conclusions:

• Many identified risk factors for SSIs are related to surgical procedures and surgeon-specific elements.
• Implementing strategies to control modifiable risk factors can lead to reduced SSI rates and improved patient outcomes.