A Study on Surgical Site Infections (SSI) and Associated Factors in A Tertiary Care Teaching Hospital

Abstract

Surgical site infections (SSI) are the most common nosocomial infection and frequently cause morbidity and mortality among inpatients of hospitals. The incidence varies from hospital to hospital. Several factors affect the development of SSI. Objectives:To study the incidence of and identify the risk factors for Surgical Site Infections in the surgical wards of the tertiary care hospital, Chennai. Materials and Methods: Study Period: July to August 2007 Study Subjects: One hundred and eighty patients who underwent various surgeries in the General Surgery department of Tertiary care hospital. A predesigned and pretested proforma was used to collect the data. Surgical sites were examined and graded. Culture and sensitivity testing was done on infected wounds. Data was analyzed using SPSS 13 software. Results: Among 180 patients 39 (21.66%) developed surgical site infections (SSI). Of 39 SSIs 20 were grade 3 and 19 were grade 4 infections. SSIs were found more commonly among the aged, males, underweight and overweight, anaemics, diabetics, hypertensives, patients with longer preoperative waiting time, with multiple blood transfusions and without antibiotic prophylaxis. Age, Sex, BMI, Diabetes mellitus, Blood transfusion and pre operative waiting had univariate statistical signifi cance. Gender, extreme BMI, Diabetes mellitus and Blood transfusion remained independent predictors of surgical site infection in multivariate analysis. Most of the SSIs yielded multiple organisms and Staphylococcus aureus was the predominant. Resistance to tetracycline was most common. Conclusion:The incidence of SSI is high. Gender, extremes of BMI, diabetes mellitus and blood transfusion are the important risk factors for it.