Evaluation of Surgical Site Infections in Abdominal Surgeries: Risk Factors, Microbial Patterns, and Prevention Strategies in a Tertiary Care Setting

Abstract

Background: Surgical site infections (SSIs) are a leading cause of postoperative
morbidity in abdominal surgeries, contributing to prolonged hospital stay and
increased healthcare costs. Understanding the risk factors and microbial profiles is
essential for effective prevention and management.
Objective: To evaluate the incidence, risk factors, microbial patterns, and outcomes
of SSIs in patients undergoing abdominal surgeries in a tertiary care setting.
Methods: A prospective observational study was conducted over one year involving
100 patients undergoing elective and emergency abdominal surgeries. Clinical data
including patient demographics, comorbidities, perioperative factors, and wound
classification were collected. Patients were monitored postoperatively for SSI
development. Samples from infected wounds were cultured for microbial
identification and antibiotic susceptibility testing.
Results: The overall SSI incidence was 18%. Diabetes mellitus (50%), obesity (BMI
>25 kg/m², 61.1%), anemia, smoking, emergency surgery status, longer operative
duration (>2 hours), use of surgical drains, and contaminated wound class were
significantly associated with higher SSI risk (p < 0.05). Staphylococcus aureus
(38.9%), Escherichia coli (27.8%), and Klebsiella pneumoniae (16.7%) were the
predominant pathogens isolated. MRSA accounted for 11.1% of infections. SSIs
were associated with significantly increased mean hospital stay (12.4 ± 4.1 days vs.
5.8 ± 2.7 days; p < 0.001).
Conclusion: SSIs remain a substantial burden in abdominal surgeries, with
identifiable patient- and surgery-related risk factors. Targeted interventions,
including glycemic control, optimizing nutritional status, minimizing operative time,
and strict aseptic protocols, alongside antimicrobial stewardship, are crucial to
reducing SSIs and improving patient outcomes.