ASSESSMENT OF SURGICAL SITE INFECTIONS IN SURGERIESAT TERTIARY CARE HOSPITALS IN SOUTHERN PUNJAB,PAKISTAN; A RETROSPECTIVE STUDY

Abstract

Background: Surgical Site Infections (SSIs) constitute a significant cause of postoperative morbidity and mortality across global healthcare systems. These infections not only exacerbate clinical outcomes but also contribute substantially to increased healthcare expenditures and extended durations of hospitalization. In the context of developing nations such as Pakistan, the burden of SSIs is further compounded by infrastructural limitations, variability in perioperative practices, and constrained infection control protocols. This study was designed to evaluate the incidence of SSIs following elective and emergency general surgical procedures and to explore the association between SSIs and key predisposing factors.

Methodology: A retrospective cohort study was conducted across multiple tertiary care hospitals situated in the southern region of Punjab, Pakistan. The study analyzed clinical records of 284 patients who underwent general surgical interventions, with almost equal representation from elective and emergency surgical cohorts. Patients’ clinical data, including demographic characteristics, comorbidities, wound classification, microbial culture results, and duration of hospital stay, were extracted from institutional electronic medical records. Statistical analysis was performed using STATA version 14.0, with multivariate logistic regression employed to evaluate potential associations between SSI occurrence and relevant clinical variables.

Results & Findings:  An overall SSI rate of 9.15% (26/284) was observed. Emergency surgeries exhibited a higher SSI incidence (13%) compared to elective surgeries (9%), although this difference lacked statistical significance (p = 0.366). The risk of SSIs increased significantly with advancing age, contaminated wound class (p < 0.001), and presence of comorbidities such as diabetes and hypertension (p = 0.008). Despite universal administration of antibiotic prophylaxis, no significant protective effect was demonstrated, underscoring concerns about timing and appropriateness of antibiotic use. Staphylococcus aureus (36.37%) and Escherichia coli (31.82%) were the predominant pathogens isolated from infected wounds. Patients with SSIs had significantly longer hospital stays (mean 10.25 days) compared to uninfected patients (mean 6.98 days), indicating prolonged hospitalization as a potential risk factor.

Conclusions: SIs remain a significant postoperative complication in tertiary hospitals of Southern Punjab, influenced by patient age, wound contamination, comorbid conditions, and hospitalization duration. Effective SSI prevention requires timely and judicious use of antibiotic prophylaxis, improved perioperative care, and stringent infection control protocols. Addressing these factors can reduce SSI incidence, improving patient outcomes and optimizing healthcare resource utilization.