Incidence and Predictors of Surgical Site Infections Following Open Elective and Emergency Surgery: A Prospective Observational Study.

BACKGROUND

Surgical site infections (SSIs) are a major contributor to postoperative morbidity, particularly in low- and middle-income countries, where infection control practices may be less stringent. This study evaluated the incidence and predictors of SSIs in patients undergoing open surgeries at a tertiary hospital in Chennai, India.

METHODS

A prospective cohort study was conducted over a two-year period, including 250 patients who underwent open surgeries. Patients were monitored for SSIs from surgery until discharge. Data on patient demographics, comorbidities, lifestyle factors, and surgical variables were collected. Statistical analysis included chi-square tests and multivariate logistic regression to identify independent predictors of SSIs.

RESULTS

The overall incidence of SSIs was 22 (8.8%). Risk factors significantly associated with SSIs were diabetes mellitus 12/73 (16.4%), smoking 5/23 (21.7%), alcohol consumption 6/24 (25.0%), emergency surgery 10/53 (18.9%), and contaminated wounds 9/20 (45.0%). Multivariate logistic regression analysis identified several independent predictors of SSIs. Diabetes mellitus was significantly associated with a higher risk of SSIs (odds ratio, OR: 3.21, 95% CI: 1.41-7.30, p = 0.005), as was undergoing emergency surgery (OR: 2.93, 95% CI: 1.19-7.23, p = 0.020). The presence of contaminated wounds was found to be the strongest predictor, with an OR of 5.82 (95% CI: 2.01-16.87, p = 0.001). Smoking also showed a significant association with increased SSI risk (OR: 2.52, 95% CI: 1.01-6.29, p = 0.048). Additionally, a longer duration of surgery was independently associated with SSIs (OR: 1.86, 95% CI: 1.07-3.21, p = 0.027).

CONCLUSION

SSIs were associated with diabetes, emergency surgeries, contaminated wounds, smoking, and prolonged surgical duration. These findings may help guide targeted preventive strategies.