Objective: To assess the surgical site infection (SSI) in adult patients in a general surgical ward.
Methodology: This prospective, observational study was conducted in the Department of Surgery, Isra University Hospital, Hyderabad. From January 1, 2016 to December 30, 2017 and included 195 patients. Patients with pregnancy, diabetes, children below age 12 years, smoking and on corticosteroid therapy were excluded from the study. The diagnosis of wound infection was made on clinical basis. The type of SSI was graded from I to IV i.e. Grade I for itching and redness, Grade II a for seroma, Grade II b for hematoma, Grade II c for seropurulent discharge, Grade III a for partial while Grade III b for complete wound dehiscence and Grade IV enterocutaneous fistula formation. Skin incision to skin closure time was recorded
Results: There were 45.61% clean, 28.71% clean contaminated and contaminated, while 25.64% dirty surgeries. SSI occurred in total 11.7% operated cases; 21.73% in Clean, 34.78% in clean contaminated and contaminated and 43.47% in dirty cases. Operations lasting more than 60 minutes had SSI in 12 (52%) patients out of total 23 (11.7%) cases.
Conclusion: Sterilization techniques and use of prophylactic antibiotics were the useful measures in controlling the surgical site infection; however the late presentation of patients with systemic inflammatory syndrome or with multi organ failure syndrome following the generalized (focal) peritonitis were the leading causes of severe form of SSI like wound dehiscence and enterocutaneous fistula formation.
Wound infection, post operation, wound dehiscence, entero cutaneous fistula formation