Surgical Site Infection After Trauma Laparotomy: A Concise Review

Surgical site infections (SSIs) are postoperative complications after trauma laparotomy, associated with increased length of hospital stay, readmission rates, and health care costs. Despite their clinical relevance, SSI incidence after trauma laparotomies varies widely in the literature.

To provide a concise review of risk factors for SSI and perioperative management strategies in trauma laparotomies.

A literature review was conducted through PubMed and Google Scholar from database inception through February 2026 using the keywords "trauma laparotomy," "damage-control laparotomy," "surgical site infections in trauma," and "surgical site infection risk factors." Studies were screened for SSI as a reported outcome, and the reference lists of selected articles were reviewed to identify additional relevant sources.

Seventeen studies were included in the analysis. Surgical site infection incidence ranged from 2.4% to 12.9% for superficial SSIs, 1.5%-4.0% for deep SSIs, and 1.3%-16.2% for organ/space SSIs. Risk factors associated with increased rates of SSI were obesity, blood transfusion volume, hollow viscus injury, colonic injury, greater number of organs injured, and damage-control laparotomy. Adherence to the Surgical Care Improvement Project guidelines for antibiotic prophylaxis was associated with a lower SSI incidence, but the evidence regarding primary skin closure and the mechanism of injury remains conflicting.

The heterogeneity of current evidence, driven by single-center retrospective designs, limits definitive conclusions. Randomized controlled trials and standardized multicenter studies are needed to advance understanding and reduce SSI burden in the trauma population. However, current evidence can guide perioperative care, including antibiotic prophylaxis, wound management, and SSI surveillance.