Surgical-site infections in emergency abdominal paediatric surgeries at a tertiary-care hospital in Pakistan
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Published on: September 11, 2018
Ali Faisal Saleem1, Huma Faiz Halepota2, Hasaan Omar3
1Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi.
Insights
In emergency pediatric abdominal surgery, pre-surgery wound status is a key indicator for surgical site infection (SSI) risk. Escherichia coli was the most common pathogen identified.
Area of Science:
- Pediatric Surgery
- Infectious Disease Epidemiology
- Surgical Site Infections
Background:
- Surgical site infections (SSI) are a significant concern in pediatric abdominal surgery.
- Understanding risk factors for SSI is crucial for improving patient outcomes.
- Previous research has explored various factors, but pre-operative wound status in emergency pediatric cases requires further investigation.
Purpose of the Study:
- To evaluate postoperative surgical site infection rates in emergency pediatric abdominal surgery.
- To identify potential risk factors associated with SSI in this patient population.
- To determine if pre-surgical wound status is an indicator of post-operative SSI risk.
Main Methods:
- Retrospective chart review of pediatric patients (neonates to 18 years) undergoing acute surgical abdominal exploration from 2012-2016.
- Estimation of surgical site infection (SSI) incidence.
- Statistical analysis including p-value, chi-square, and non-parametric tests to compare pre- and post-surgical pathogen occurrence and wound status. Pathogen occurrence trends were plotted.
Main Results:
- Escherichia coli was the most common pathogen (n=10).
- Contaminated pre-operative wounds were significantly associated with higher SSI rates (p=0.036, OR 1.95).
- No significant difference was found between pre- and post-surgical pathogens in patients discharged in stable condition.
Conclusions:
- Pre-surgery wound status is a significant indicator for the risk of developing surgical site infections (SSI) in pediatric patients undergoing emergency abdominal surgery.
- Early identification and management of wound contamination pre-operatively may help reduce SSI rates.
- Further prospective studies are warranted to confirm these findings and develop targeted interventions.
Abstract:
A retrospective chart review was carried out in children (neonates to 18 years) who underwent acute surgical abdominal exploration during 2012-2016 at the Aga Khan University Hospital, Karachi, to evaluate the postoperative surgical site infection rates in emergency paediatric abdominal surgery. Incidence of surgical site infection (SSI) was estimated. P-value was calculated, chisquare and non-parametric tests were performed by comparing pre-surgical and post-surgical procedure pathogen occurrence and pre-procedure wound status. Pathogen occurrence related to time-trend of 98 paediatric patients who underwent emergency abdominal surgery was plotted. Of the 94 who were discharged in stable condition, it was found that there was no significant difference between pre- and postsurgical pathogens. Escherichia coli (n=10) was found to be the most common pathogen. Contaminated wounds were associated with higher SSI (p=0.036, OR 1.95 95% CI 0.7-5.4). The study found that pre-surgery wound status could be an indicator for risk of SSI in a post-operative scenario.
