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Risk factors and outcomes of surgical site infection after abdominoplasty: A retrospective study from Qatar
Humberto Guanche Garcell1, Yamile Leon Rodriguez2, Orlando Rafael Exposito Reyes2
1Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar.
Background:
Abdominoplasty, although classified as a clean elective procedure, carries a meaningful risk of surgical site infection (SSI), with reported SSI rates varying depending on patient factors and procedural complexity.
Objective:
To describe SSI incidence and associated risk factors after abdominoplasty at a Qatari tertiary facility, and to assess compliance with prophylaxis practices, antibiotic consumption, and costs.
Methods:
Retrospective cohort of all abdominoplasties at The Cuban Hospital, from January 1, 2022, to July 31, 2025 (N = 323). Data included demographics, comorbidities, perioperative glucose monitoring, procedure characteristics, and antibiotic use (prophylactic and therapeutic). The cohort comprised both simple abdominoplasties and combined procedures performed with additional interventions such as liposuction or hernia repair. SSI rates were analyzed using relative risk, 95% confidence intervals, and statistical tests with significance at P < 0.05.
Results:
A total of 323 patients underwent abdominoplasty with a mean age of 40.5 years (SD, 9.8; range, 19-63 years). The majority were female (276 patients, 85.4%), and 13.9% (45 patients) had a history of diabetes mellitus. Overall SSI incidence was 5.3% (17/323), highest in 2025 (8/112; 7.1%). Combined abdominoplasty had a higher SSI rate than simple procedures (10.4% [5/48] vs. 4.4% [12/275]; RR, 2.36 [95% CI, 0.88-6.35]). SSI was more frequent with diabetes (11.1% [5/45] vs. 4.3% [12/278]), overweight/obesity (7.3% [12/151]/4.3% [5/112] vs. 0% [0/42]), and higher postoperative glucose (mean: 7.97, standard deviation: 1.99; P = 0.04). Adherence to antibiotic prophylaxis was high for timing/selection/dose, but discontinuation beyond 24 hours and 7-day discharge prescriptions were common. Antibiotic consumption and costs were higher in SSI cases (355.9 vs. 280.5 DDD/100; 2807.6 vs. 2180 QR/100; P = 0.45; P = 0.72).
Conclusion:
SSI incidence after abdominoplasty was modest but increased with combined procedures and poorer postoperative glycemic control. Strengthening perioperative glucose protocols and enforcing 24-hour prophylaxis limits may reduce SSI and unnecessary antimicrobial use and costs.
Insights
Surgical site infection (SSI) after abdominoplasty is linked to combined procedures and high postoperative glucose levels. Improving glucose control and limiting antibiotic prophylaxis duration can reduce SSIs and healthcare costs.
Area of Science:
- Plastic Surgery
- Infectious Disease Epidemiology
- Healthcare Management
Background:
- Abdominoplasty, a common elective surgery, carries a significant risk of surgical site infection (SSI).
- SSI rates in abdominoplasty vary based on patient characteristics and surgical complexity.
- Understanding these factors is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of SSI following abdominoplasty procedures.
- To identify risk factors associated with SSI in this patient population.
- To evaluate antibiotic prophylaxis practices, consumption, and associated costs in Qatar.
Main Methods:
- A retrospective cohort study of 323 abdominoplasty patients at a tertiary facility in Qatar (2022-2025).
- Data collected included patient demographics, comorbidities (e.g., diabetes), perioperative glucose levels, procedure type, and antibiotic usage.
- SSI rates were analyzed using relative risk, confidence intervals, and statistical significance (P < 0.05).
Main Results:
- Overall SSI incidence was 5.3%, with higher rates in combined procedures (10.4%) versus simple abdominoplasty (4.4%).
- Diabetes, overweight/obesity, and elevated postoperative glucose levels were associated with increased SSI risk.
- While antibiotic prophylaxis adherence was high, prolonged prescriptions and discontinuation beyond 24 hours were noted. SSI cases incurred higher antibiotic consumption and costs.
Conclusions:
- Abdominoplasty carries a modest SSI risk, exacerbated by combined surgical procedures and suboptimal glycemic control.
- Enhanced perioperative glucose management and adherence to 24-hour antibiotic prophylaxis guidelines are recommended.
- These interventions may decrease SSI rates, reduce antimicrobial resistance, and lower healthcare expenditures.