Surgical site infection rates for herniorrhaphy and cholecystectomy in a tertiary care hospital in Saudi Arabia.

We carried out a surveillance study to calculate 2007 rates of surgical site infection (SSI) for herniorrhaphies and cholecystectomies performed at King Abdulaziz Medical City (KAMC) in Riyadh, to compare these rates to previous KAMC rates conducted in 1999-2001 and to benchmark these rates to those reported by American National Nosocomial Infections Surveillance (NNIS) hospitals in 2004. We reviewed the charts of patients who underwent herniorrhaphy (N=113) or cholecystectomy (N=208) from January to June 2007 using the Centers for Disease Control (CDC) criteria for SSI diagnosis. The rates were calculated and stratified by the modified risk index categories, based on American Society of Anesthesiology score, wound class, procedure duration and laparoscopy use. KAMC SSI rates per 100 operations in 2007 were 0.88 for herniorrhaphy and 0.48 for cholecystectomy. After adjusting to the different risk index categories between the KAMC and NNIS, standardized infection ratios (SIR) were comparable to NNIS at 97% for herniorrhaphy (p=0.553) and 90% for cholecystectomy (p>0.90). KAMC SSI rates per 100 operations in 1999-2001 were significantly higher than the NNIS rates at 4.34 for herniorrhaphy (p <0.001) and 1.87 for cholecystectomy (p=0.036). Compared to 1999-2001 rates, KAMC SSI rates in 2007 were reduced by 80% for herniorrhaphy (p=0.049) and 74% for cholecystectomy (p=0.270). The SSI rate improvement was observed after better enforcement of infection control practices.