SURGICAL SITE INFECTIONS IN ELECTIVE VS. EMERGENCY ABDOMINAL SURGERIES: RISK FACTORS AND PREVENTIVE STRATEGIES

Abstract

Background

SSIs that occur at surgical sites cause substantial postoperative complications and force patients to stay in hospitals longer particularly among abdominal surgery patients. SSIs frequently occur after emergency operations because patients tend to be poorly optimized before surgery and surgeries carry elevated contamination risks which leads to delays in antibiotic prophylaxis timing. The successful improvement of surgical outcomes requires both correct identification of vital risk factors and the implementation of evidence-based preventive measures.

Objectives

to establish a side-by-side comparison of SSIs between elective and emergency abdominal surgeries along with the analysis of risk variables and effectiveness assessments of infection-reducing protective measures for these two surgical sets.

Study Design: A prospective Study.

Place and Duration of Study. Department of General Surgery Dow medical college /DUHS Karachi from jan 2023 to dec 2023

Methods

A prospective Study Conducted in the Department of General Surgery Dow medical college /DUHS Karachi from jan 2023 to dec 2023. The research included enrollment of 200 abdominal surgery patients with even distributions between elective surgery patients (n=100) and emergency surgery patients (n=100). The research gathered information regarding patient characteristics and surgery times along with wound types as well as medical conditions and observed superfluous surgical infection cases. Preventive measures were documented. The statistical evaluation was completed with SPSS version 24.0 while using p<0.05 as the cutoff point for significance. The investigation through multivariate analysis determined independent elements that contributed to SSI development.

Results

Of 200 patients, 42 developed SSIs: 10 in elective (10%) and 32 in emergency surgeries (32%), p<0.001. Medical staff evaluated patients whose age averaged 45.3 ± 14.2 years. Patients with diabetes and surgeries lasting more than two hours and contaminated/dirty wound status as well as no received antibiotic prophylaxis faced the highest SSI occurrence rates at 56.2%, 68.5% and 75.3% and 64.4%, respectively. The preoperative preparation in elective surgeries created better conditions which led to decreased postoperative complications. SSI rates decreased as a result of using preventive measures which included chlorhexidine bathing combined with timely antibiotics administration and glycaemic control. Evidence shows that infection rates distinguished both groups from each other statistically.

Conclusion

Emergency abdominal surgeries tend to experience more SSIs because they have greater wound contamination and worse surgical preparation. SSI development is directly linked to three primary risk elements that consist of diabetes together with extended surgical duration and untimely antibiotic use. The implementation of evidence-based preventive measures decreases the occurrence of SSI. Standard operating procedures need to be implemented rigorously at all times to enhance operative success metrics and decrease emergency hospitalization lengths together with healthcare expenses.