EXPLORING THE IMPACT OF RISK FACTORS, PREVENTIVE MEASURES, AND MANAGEMENT STRATEGIES ON SURGICAL SITE INFECTIONS IN GENERAL SURGERY: A COMPREHENSIVE ASSESSMENT

Authors

  • Hamid ur Rehman Jinnah International Hospital Abbottabad-Pakistan
  • Atif Iqbal Jinnah International Hospital Abbottabad-Pakistan
  • Ibrar Ahmad Abbottabad International Hospital Abbottabad-Pakistan
  • Hina Fayyaz Jinnah International Hospital Abbottabad-Pakistan
  • Liaqat Ali Health Department
  • Javed Iqbal Health Department
  • Qazi Mohammad Hameed Jinnah International Hospital Abbottabad-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-13499

Keywords:

Surgical site infections, risk factors, preventive measures, management strategies, general surgery

Abstract

Background: Surgical site infections (SSIs) pose significant challenges in healthcare, leading to prolonged hospital stays, increased morbidity, and economic burden. Understanding the interplay between risk factors, preventive measures, and management strategies is crucial for effective infection control in general surgery.  This study aimed to comprehensively assess the impact of various risk factors, preventive measures, and management strategies on surgical site infections in the context of general surgery. Methods: The study was conducted atJinnah International Hospital Abbottabad, involving a study population of 120 patients undergoing general surgical procedures from May 2023 to April 2024. A retrospective analysis of patient records was performed to identify risk factors associated with SSIs. Additionally, preventive measures implemented preoperatively, intraoperatively, and postoperatively were evaluated. Management strategies employed for treating SSIs were also reviewed. Results: The analysis revealed several significant risk factors contributing to the development of SSIs, including comorbidities, prolonged surgical duration, and inadequate preoperative preparation. Preoperative measures such as appropriate patient screening and optimization, intraoperative techniques like strict aseptic protocols, and postoperative interventions such as timely wound care significantly influenced SSI rates. Furthermore, effective management strategies such as early detection, antimicrobial therapy, and surgical debridement played pivotal roles in controlling SSIs and reducing associated complications. Conclusion: Our findings underscore the importance of a multifaceted approach involving identification of risk factors, implementation of preventive measures, and prompt management strategies to mitigate the incidence and impact of surgical site infections in general surgery. Comprehensive infection control protocols tailored to individual patient needs are essential for optimizing surgical outcomes and enhancing patient safety.

References

Gillespie BM, Harbeck E, Rattray M, Liang R, Walker R, Latimer S, Thalib L, Andersson AE, Griffin B, Ware R, Chaboyer W. Worldwide incidence of surgical site infections in general surgical patients: A systematic review and meta-analysis of 488,594 patients. International Journal of Surgery. 2021 Nov 1;95:106136.

Xu Z, Qu H, Kanani G, Guo Z, Ren Y, Chen X. Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis. International journal of colorectal disease. 2020 Dec;35:2147-56.

Tomsic I, Heinze NR, Chaberny IF, Krauth C, Schock B, von Lengerke T. Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC health services research. 2020 Dec;20:1-21.

Shiferaw WS, Aynalem YA, Akalu TY, Petrucka PM. Surgical site infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC surgery. 2020 Dec;20:1-5.

Losurdo P, Paiano L, Samardzic N, Germani P, Bernardi L, Borelli M, Pozzetto B, de Manzini N, Bortul M. Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study. Updates in Surgery. 2020 Dec;72:1263-71.

Mentor K, Ratnayake B, Akter N, Alessandri G, Sen G, French JJ, Manas DM, Hammond JS, Pandanaboyana S. Meta-analysis and meta-regression of risk factors for surgical site infections in hepatic and pancreatic resection. World journal of surgery. 2020 Dec;44:4221-30.

Calderwood MS, Anderson DJ, Bratzler DW, Dellinger EP, Garcia-Houchins S, Maragakis LL, Nyquist AC, Perkins KM, Preas MA, Saiman L, Schaffzin JK. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. Infection Control & Hospital Epidemiology. 2023 May;44(5):695-720.

Mehtar S, Wanyoro A, Ogunsola F, Ameh EA, Nthumba P, Kilpatrick C, Revathi G, Antoniadou A, Giamarelou H, Apisarnthanarak A, Ramatowski JW. Implementation of surgical site infection surveillance in low-and middle-income countries: A position statement for the International Society for Infectious Diseases. International Journal of Infectious Diseases. 2020 Nov 1;100:123-31.

Shiroky J, Lillie E, Muaddi H, Sevigny M, Choi WJ, Karanicolas PJ. The impact of negative pressure wound therapy for closed surgical incisions on surgical site infection: a systematic review and meta-analysis. Surgery. 2020 Jun 1;167(6):1001-9.

Li Z, Li H, Lv P, Peng X, Wu C, Ren J, Wang P. Prospective multicenter study on the incidence of surgical site infection after emergency abdominal surgery in China. Scientific reports. 2021 Apr 8;11(1):7794.

Kantzanou M, Korfias S, Panourias I, Sakas DE, Karalexi MA. Deep brain stimulation-related surgical site infections: a systematic review and meta-analysis. Neuromodulation: Technology at the Neural Interface. 2021 Feb 1;24(2):197-211.

Cochetti G, Abraha I, Randolph J, Montedori A, Boni A, Arezzo A, Mazza E, De Vermandois JA, Cirocchi R, Mearini E. Surgical wound closure by staples or sutures?: Systematic review. Medicine. 2020 Jun 19;99(25):e20573.

Monahan M, Jowett S, Pinkney T, Brocklehurst P, Morton DG, Abdali Z, Roberts TE. Surgical site infection and costs in low-and middle-income countries: A systematic review of the economic burden. PloS one. 2020 Jun 4;15(6):e0232960.

Kittle H, Ormseth A, Patetta MJ, Sood A, Gonzalez MH. Chronic corticosteroid use as a risk factor for perioperative complications in patients undergoing total joint arthroplasty. JAAOS Global Research & Reviews. 2020 Jul 1;4(7):e20.

Hagen CR, Singh A, Weese JS, Marshall Q, Linden AZ, Gibson TW. Contributing factors to surgical site infection after tibial plateau leveling osteotomy: A follow‐up retrospective study. Veterinary Surgery. 2020 Jul;49(5):930-9.

Cooper L, Sneddon J, Afriyie DK, Sefah IA, Kurdi A, Godman B, Seaton RA. Supporting global antimicrobial stewardship: antibiotic prophylaxis for the prevention of surgical site infection in low-and middle-income countries (LMICs): a scoping review and meta-analysis. JAC-Antimicrobial Resistance. 2020 Sep;2(3):dlaa070.

Getaneh T, Negesse A, Dessie G. Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis. BMC pregnancy and childbirth. 2020 Dec;20:1-1.

Mwita JC, Ogunleye OO, Olalekan A, Kalungia AC, Kurdi A, Saleem Z, Sneddon J, Godman B. Key issues surrounding appropriate antibiotic use for prevention of surgical site infections in low-and middle-income countries: a narrative review and the implications. International journal of general medicine. 2021 Feb 18:515-30.

Gao J, Wang Y, Song J, Li Z, Ren J, Wang P. Negative pressure wound therapy for surgical site infections: a systematic review and meta‐analysis. Journal of Advanced Nursing. 2021 Oct;77(10):3980-90.

Basany EE, Solís-Peña A, Pellino G, Kreisler E, Fraccalvieri D, Muinelo-Lorenzo M, Maseda-Díaz O, García-González JM, Santamaría-Olabarrieta M, Codina-Cazador A, Biondo S. Preoperative oral antibiotics and surgical-site infections in colon surgery (ORALEV): a multicentre, single-blind, pragmatic, randomised controlled trial. The lancet Gastroenterology & hepatology. 2020 Aug 1;5(8):729-38.

Tsantes AG, Papadopoulos DV, Lytras T, Tsantes AE, Mavrogenis AF, Koulouvaris P, Gelalis ID, Ploumis A, Korompilias AV, Benzakour T, Tsivgoulis G. Association of malnutrition with surgical site infection following spinal surgery: systematic review and meta-analysis. Journal of Hospital Infection. 2020 Jan 1;104(1):111-9.

Cousin AS, Bouletreau P, Giai J, Ibrahim B, Louvrier A, Sigaux N. Severity and long-term complications of surgical site infections after orthognathic surgery: a retrospective study. Scientific reports. 2020 Jul 21;10(1):12015.

Tan DJ, Yaow CY, Mok HT, Ng CH, Tai CH, Tham HY, Foo FJ, Chong CS. The influence of diabetes on postoperative complications following colorectal surgery. Techniques in coloproctology. 2021 Mar;25:267-78.

Edafe O, Cochrane E, Balasubramanian SP. Reoperation for bleeding after thyroid and parathyroid surgery: incidence, risk factors, prevention, and management. World journal of surgery. 2020 Apr;44:1156-62.

Balakirski G, Löser CR, Dippel E, Yazdi AS, Artamonova I, Megahed M, Schmitt L. Surgical site infections after microscopically controlled skin surgery in immunocompromised patients: a retrospective two-center cohort study. Archives of Dermatological Research. 2020 Sep;312:491-9.

Downloads

Published

2024-06-30