International Surgery Journal | August 2021 | Vol 8 | Issue 8 Page 2311
International Surgery Journal
Tolpadi AG et al. Int Surg J. 2021 Aug;8(8):2311-2317
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Surgical site infections in clean and clean contaminated surgeries in a
tertiary care teaching hospital
Anuradha G. Tolpadi
1
, Abhijeet K. Mane
1
*, Snehal V. Dhayagude
1
, Meera S. Modak
1
,
Dhananjay M. Dongare
2
, Akshata S. Tendulkar
2
, Prerana U. Mahadik
2
, Pallavi Lamkhade
2
INTRODUCTION
Health care-associated infections (HAI) are a major
public health problem. Even after infection control
interventions it still remains a major threat to patient
safety.
1,2
Surgical site infections (SSI) are one of the most common
HAIs.
3
Incidence varies worldwide. It is estimated that
SSI occurs in at least 2% of surgeries.
4
SSI incidence is
higher in developing countries.
1
In India the risk of
acquiring SSI ranges from 4%-30%.
5
In India
surveillance data is still scanty and prevention of HAI is
not always priortized.
1,6
SSI and its adverse effects on
patients and healthcare system can be prevented by
evidence based surveillance system. This will ensure
patient safety and reduce the additional financial burden.
Ultimately it will assist in improving quality of health
care.
4
ABSTRACT
Background: Despite major advances in infection control interventions, health care-associated infections (HAI)
remain a major public health problem and patient safety threat worldwide. Surgical site infections (SSI) are among the
most commonly reported Hospital acquired infections (HAI).
Methods: This was a prospective observational study conducted in a tertiary care hospital over a period of one year
from May 2019 to April 2020. Total 2382 patients who underwent clean and clean contaminated surgeries were
included in the study. The data on demographics, type of surgery, duration of surgery, day of SSI event, use of
prosthesis, comorbidities, post-operative stay and resuturing was collected and analyzed. From suspected patients of
SSI, pus aspirate/swab was sent for culture and susceptibility.
Results: Total 2382 clean and clean contaminated surgeries were included in the study. The incidence of SSI was
2.05%. Association between SSI and gender, age group and whether the surgeries were planned or were emergency
surgeries was noted. In 37 (75.51%) patients who developed SSI the post-operative stay was prolonged (>7days). 3
(6.1%) patients had to undergo resuturing due to gaping in the surgical wound. 18(36.73%) cases of SSI were
diagnosed after discharge from hospital. The predominant organism causing SSI was Escherichia coli followed by
Staphylococcus aureus and Coagulase negative Staphylococcus (CONS).
Conclusions: Regular surveillance of SSI with feedback of appropriate data to the stakeholders is desirable to reduce
SSI rate. Post patient discharge, surveillance of SSI is challenging but it needs to be addressed by infection control
team to identify cases of SSI accurately.
Keywords: Surveillance, Surgical antibiotic prophylaxis, Surgery, Comorbidities
1
Department of Microbiology, Bharati Vidyapeeth (DTU) Medical College and Hospital, Pune, Maharashtra, India
2
Infection Control Department, Bharati Hospital and Research Centre, Pune, Maharashtra, India
Received: 25 May 2021
Accepted: 01 July 2021
*Correspondence:
Dr. Abhijeet K. Mane,
E-mail: drakmane@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20212793