Khan Kazim Raza, Kumari Jaya, Haider Syed Muhammad Waqar, Fawwad Shaikh Basiq Ul, Kumar Narindar, Nizar Rukhsar, Kumar Deepak, Hasan Mohammad, Mumtaz Hassan
Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Internal Medicine, Mehran Medical Center, Karachi, PAK.
Cureus. 2022 Jul 26;14(7):e27320. doi: 10.7759/cureus.27320. eCollection 2022 Jul.
Background Surgical site infection (SSI) is the most commonly occurring infection in postoperative patients. This study is conducted to evaluate the prevalence of SSI in patients following gastrointestinal tract surgery and identify the risk factors. Method A cross-sectional study was conducted at the Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan, between December 2021 and May 2022. A total of 132 patients participated in the study who were at least 18 years older and had undergone the gastrointestinal surgical procedure. Patients who refused to give consent, died after the procedure, and were diagnosed with SSI after they were discharged were excluded from the study. We performed a chi-squared test. Result A total of 132 patients were included in the study, of which 63 (47.7%) were males, while 69 (52.3%) were females. SSI was more commonly found among the age group of 41-70 years with 29 (38.7%) patients. Presurgical features including hemoglobin of >11 mg/dL, albumin of >3.5 g/dL, blood glucose of <80 mg/dL, and emergency surgery were found to be associated with the SSI having a significant p-value. Similarly, the surgical and postsurgical features significantly associated with the SSI having a significant p-value were the presence of surgical trauma, wound irrigation with normal saline, malignancy, bowel preparation, longer duration of the surgery, intraoperative hypotension, operative site, drain insertion, and the absence of a second antibiotic. Conclusion The early identification and management of the demographical, presurgical, surgical, and postsurgical risk factors can help reduce the incidence of SSIs. Bowel preparation should be encouraged, and unnecessary delays during the surgical process leading to increased procedure time should be avoided. Extra precaution needs to be provided for the patients highly susceptible to SSIs.
背景 手术部位感染(SSI)是术后患者最常见的感染。本研究旨在评估胃肠道手术后患者SSI的患病率,并确定危险因素。方法 2021年12月至2022年5月在巴基斯坦卡拉奇的真纳研究生医学中心(JPMC)进行了一项横断面研究。共有132名年龄至少18岁且接受过胃肠道手术的患者参与了该研究。拒绝给予同意、术后死亡以及出院后被诊断为SSI的患者被排除在研究之外。我们进行了卡方检验。结果 共有132名患者纳入研究,其中63名(47.7%)为男性,69名(52.3%)为女性。SSI在41 - 70岁年龄组中更为常见,有29名(38.7%)患者。术前特征包括血红蛋白>11 mg/dL、白蛋白>3.5 g/dL、血糖<80 mg/dL以及急诊手术,被发现与SSI相关,p值具有显著性。同样,与SSI显著相关且p值具有显著性的手术及术后特征包括手术创伤的存在、用生理盐水冲洗伤口、恶性肿瘤、肠道准备、手术时间较长、术中低血压、手术部位、引流管插入以及未使用第二种抗生素。结论 对人口统计学、术前、手术及术后危险因素的早期识别和管理有助于降低SSI的发生率。应鼓励进行肠道准备,避免手术过程中导致手术时间延长的不必要延误。对于极易发生SSI的患者需要采取额外的预防措施。