Vol. 8, Issue 4, Part B (2024)

Objective: In order to establish the host and environmental factors contributing to SSIs in the setting of emergency non-traumatic abdominal operations.

Methods: This descriptive cross-sectional study was carried out at Mymensingh Medical College Hospital, Bangladesh, on 140 patients who were undergoing emergency non-traumatic abdominal operations during the period from August 2009 to July 2010. Registration information of these patients, details of operation, and patient’s data after operation were obtained. Swabs from the wound discharge were inoculated to determine which organisms are likely to have caused the infection and their sensitivity to antibiotics were determined.

Results: The overall SSI rate was 17.14%. SSI rates were higher in patients with co-morbidities (40.48% vs 7.14%, p<0.001), longer operative times (60% for > 2 hours vs 4.6% for < 1 hour, p<0.001), and contaminated/dirty wounds (32.61% vs 4.35% for clean wounds, p<0.01). Delayed surgery initiation and midline incisions were associated with increased SSI rates. E. coli (45.83%) and S. aureus (37.50%) were the most common isolates. All isolates were sensitive to imipenem.

Conclusion: This study found that there are both host-related factors (co-morbidities and nutritional status of patient) and environmental factors (contaminated wound, operative time, and the type of surgical procedures performed) that predispose the emergency abdominal surgery patient to SSI. The common organisms responsible for such presentations are gram-negative organisms, of which E. coli is the most frequent isolate. Improving other modifiable risk factors; appropriate use of antibiotics; and maintaining compliance with basic surgical principles of aseptic surgery are important in decreasing SSI. In developing countries, because of uncontrolled growth of resident flora in wounds and tissues, it may be essential to use prophylactic antibiotics to prevent SSIs.