Surgical Site Infection After Abdominal Surgery: Distribution and Determinants From a Cross-Sectional Study

Surgical site infections (SSIs) remain one of the most common postoperative complications, particularly following abdominal surgeries, contributing significantly to patient morbidity, prolonged hospitalization, and healthcare costs. Despite advancements in surgical practices, SSI rates remain high in many low- and middle-income countries, including India.

This study aimed to estimate the distribution pattern of SSIs following abdominal surgeries and to identify associated risk factors in patients operated on at a tertiary care hospital in Chennai.

A cross-sectional study was conducted over an 18-month period at Sree Balaji Medical College and Hospital. A total of 70 patients who underwent abdominal surgeries were included based on defined inclusion criteria. Data were collected using a semi-structured proforma, covering demographic, clinical, surgical, and microbiological parameters. SSI was diagnosed based on clinical criteria and confirmed with wound swab cultures when necessary. Statistical analyses included descriptive statistics, chi-square tests, and logistic regression to determine significant associations.

The incidence of SSI in the study population was 22.9%, which was 16 out of 70 patients. SSIs were more common in patients with diabetes mellitus (31.4%), prolonged preoperative hospital stays (> three days), and those who underwent open surgeries (SSI rate: 31%). Dirty wounds had the highest infection rate (60%), while laparoscopic procedures had significantly lower SSI rates (10.7%). Multivariate logistic regression identified prolonged surgery (> two hours), dirty wound classification, preoperative stay > three days, and diabetes as independent predictors of SSI. The most commonly isolated organism was Escherichia coli, followed by Staphylococcus aureus, with notable resistance to first-line antibiotics.

SSIs following abdominal surgeries are influenced by multiple interrelated factors, many of which are preventable. Identification of high-risk patients, timely prophylactic antibiotic administration, minimally invasive approaches, and strict adherence to aseptic techniques are key to reducing infection rates. The findings from this study highlight the need for targeted infection control strategies and antimicrobial stewardship in Indian surgical settings.