Incidence and risk factors for surgical site infection following emergency laparotomy at Kenyatta National Hospital

Abstract

Background: The incidence of surgical site infection (SSI) following emergency abdominal operation contributes to significant morbidity. There are patient-related as well as perioperative risk factors that seem to contribute to this incidence. This study determined incidence and risk factors following emergency bowel surgery at Kenyatta National Hospital. Objective: To determine incidence and risk factors of surgical site infection following emergency laparotomy at Kenyatta National Hospital. Design: Prospective cross sectional study. Subjects: One hundred and twenty (120) Patients, 13 years and above scheduled to undergo emergency laparotomy. Results: Overall incidence of SSI was 30.8% with male patients having infection rate of 20.8%, while patients who consumed alcohol had infection rate of 5.8%. Incidence of SSI was highest in patient who had preoperative duration of 48 hours at 12% and intraoperative duration of 90 minutes at 7.5%. Dirty wounds accounted for 60% with infection rate of 26.7%. Patients with ASA score of 1 had infection rate of 23.3%, with patients who received perioperative transfusion having infection rate of 6.6%. Conclusion: Overall incidence of SSI is high, majority of patients were male who were young with ASA score of one had highest rate of infection. Prolonged preoperative and intraoperative duration, dirty wounds and perioperative transfusion was associated with increased rate of SSI. Surveillance on SSI by surgical team, public health education on alcohol and cigarettes consumption, prompt surgical intervention and judicial use of blood could reduce incidence of SSI.