Atumanyire Jethro, Muhumuza Joshua, Talemwa Nelson, Molen Selamo Fabrice, Kithinji Stephen Mbae, Kagenderezo ByaMungu Pahari, Hakizimana Theoneste
Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka Bushenyi, Uganda.
Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda.
Int J Surg Open. 2023 Jul;56:100641. doi: 10.1016/j.ijso.2023.100641. Epub 2023 Jun 13.
Surgical site infection (SSI) is the commonest form of hospital acquired infection in sub-Saharan Africa, associated with increased morbidity and mortality. This study was aimed at determining the incidence and outcomes of surgical site infection following emergency laparotomy during the COVID -19 pandemic in a low resource setting.
This was a retrospective single Centre cohort of patients that had emergency laparotomy between July 2021-June 2022 (COVID period) and July 2018-June 2019 (pre-COVID period). Analysis was done using SPSS version 22 in which SSI rates were compared between the two periods using the chi squared test. Mortality, re-operation rates and length of hospital stay were also compared.
Of the 453 patient files included in analysis, 244 (53.9%) were for the COVID period, while 209 (46.1%) were for the pre COVID period. The incidence of SSI was insignificantly higher in the COVID period (17.6% versus 16.7%; P = 0.901). Mortality was also insignificantly higher in the SSI group (3.8% versus 3.5%; P = 0.745). Presence of surgical site infection increased the risk for re-operation (P < 0.001) and prolonged hospital stay (P < 0.001).
Since the incidence and outcomes of surgical site infection appear not to have changed following the pandemic, the same measures that were previously used to prevent SSI could still be effective even during the pandemic if followed appropriately and combined with the COVID specific peri-operative care recommendations.
手术部位感染(SSI)是撒哈拉以南非洲地区最常见的医院获得性感染形式,与发病率和死亡率增加相关。本研究旨在确定在资源匮乏地区,新冠疫情期间急诊剖腹手术后手术部位感染的发生率和结局。
这是一项回顾性单中心队列研究,研究对象为2021年7月至2022年6月(新冠疫情期间)和2018年7月至2019年6月(新冠疫情前)期间接受急诊剖腹手术的患者。使用SPSS 22版进行分析,通过卡方检验比较两个时期的SSI发生率。还比较了死亡率、再次手术率和住院时间。
纳入分析的453份患者病历中,244份(53.9%)为新冠疫情期间的病历,209份(46.1%)为新冠疫情前的病历。新冠疫情期间SSI的发生率略高,但无统计学意义(17.6%对16.7%;P = 0.901)。SSI组的死亡率也略高,但无统计学意义(3.8%对3.5%;P = 0.745)。手术部位感染的存在增加了再次手术的风险(P < 0.001)和延长了住院时间(P < 0.001)。
由于疫情后手术部位感染的发生率和结局似乎没有变化,如果适当遵循并结合新冠疫情特定的围手术期护理建议,以前用于预防SSI的相同措施即使在疫情期间可能仍然有效。