Incidence, risk factors and outcomes of surgical site infections following elective and emergency surgery – A hospital based Crosssectional study

Abstract

Background - Wound Healing is the summation of a number of processes that follow injury. Despite immense advances in the technique of wound creation and closure, there continues to be an important percentage of patients undergoing abdominal operations, suffering from delayed wound healing and partial wound failure. The incidence of post-operative wound dehiscence was investigated in patients in several studies (e.g., 1.25 per 1,000 discharges at 0 to 17 years, 1.74 at 18 to 44 years, 2.65 at 45 to 65 years, and 3.77 at 65 or more years. Additionally, it was found that this complication resulted in an increased mean length of stay (by 21.1 days) and a tremendous increase in charges for affected patients, with 5.7 times higher odds of in-hospital mortality. Wound Infection rate varies from 6.8 percent to 21.4 percent depending on the procedure and other patient factors. Aim of study - To assess the various factors influencing post laparotomy wound healing. To identify the pre-operative, operative and post operative risk factors in patients having poor wound healing. Materials and methods - This prospective study was conducted in the Department of General Surgery, VIMSAR, burla ,sambalpur. Results - A total of 100 patients undergoing laparotomies were studied .40 patients were found to have
delayed wound healing. The strongest association for delayed healing was found to be wound infection, followed by smoking, chronic cough, poorly controlled diabetes and alcohol. The incidence of delayed healing was found to be higher in present study with increased incidence of wound infection. Emergency laparotomies were associated with an increased incidence of wound infection and thereby delayed healing. Conclusion - Poor wound healing is also associated strongly with poor nutrition and uncontrolled diabetes. These factors should be taken into account and efforts have to be made to correct the risk factors pre or post-operatively.