Surgical Site Infections in Indigenous Populations of the United States and Canada: A Scoping Review

Several studies have highlighted higher rates of adverse outcomes such as superficial surgical site infection (SSI) in Indigenous populations. However, there is a paucity of literature amalgamating reports of SSI in these populations compared with other ethnic and racial groups. The aim of this review is to highlight the incidence of SSI in Indigenous populations in the United States and Canada compared with non-Indigenous patients.

Based upon systematic assessment of relevant articles found in Scopus, PubMed, and PubMed Central, a state-of-the-art review was conducted. Studies in English that were cohort, cross-sectional, case-control, or randomized controlled studies on human beings of all ages and genders were included. Studies that were reviews, case series, case reports, editorials, letters to editors, animal studies, or studies that did not examine SSI as a direct outcome of surgical procedure were excluded.

We retrieved 1,718 articles, 9 of which were included for review. The most reported adverse surgical infection was superficial SSI. Five studies reported statistically significant increased risk of superficial SSI in Indigenous populations compared with White patients. Increased rates of deep incisional SSI for Indigenous populations compared with White patients were statistically significant in two of three studies looking at this outcome. As it relates to organ-space SSI, two studies reported statistically significant increases for Indigenous patients of the three studies reporting this parameter.

There are statistically significant differences in the incidence of SSI for Indigenous patients, particularly when compared with their White counterparts.