医療インプラントと外科

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Prevalence of Surgical Site Infections in Non-Diabetic Patients Undergoing Major Surgery at St. Francis Hospital Nsambya

Magezi Moses

Surgical site infection (SSI) is an infection occurring in an incision wound within 30 days of surgery and significantly effects patient recovery and hospital resources. To determine the prevalence of SSI among non-diabetic patients undergoing major surgery at St.Francis hospital Nsambya. This was a Cross-section prospective study, the study was carried out at St. Francis Hospital Nsambya in Kampala. This is one of the tertiary level referral and teaching hospital for MKPG Nkozi University. It has a bed capacity 342 beds. Approval to conduct the study was obtained from the institutional review board prior to commencement of data collection. Of the 140 patients enrolled in the study, male were 90 (64.3%) giving male female ratio 1.8:1. Surgical site infection (SSI) was seen in 40 (28.6%) patients and these were. 3 (2.1%) stitch abscess (sinus), 22 (15.7%) superficial SSIs, 10 (7.1%) deep SSIs, and 5 (3.6) deep space infection. Common bacteria isolated were: Staphylococcus aureus 10 (27.8%) and Escherichia coli 10 (27.8%). SSI was significantly associated with; co-morbidities (P-value=0.05), history of smoking (P-value=0.008), type of procedure done (P-value=0.03), ASA (P-value=0.001), type of surgery (P-value=0.012), use of drain (P-value=0.011), increased WCC (P-value=0.001), Neutrophilia (P-value=0.001), Hypoalbuminemia (P-value=0.001), BG levels at various intervals; preoperative at induction, post-operative at 12 hous, 24 hours, and 48 hours (P-value=0.007), (P-value=0.002), (P-value=0.005), (P-value=0.007) respectively, significantly were associated with SSI. Considering the relatively higher rate of SSI in this study, especially in non-diabetic patient undergoing major surgery. Surgical wound contamination potential, patients clinical conditions (ASA), type of surgical procedure, Leukocytosis, hypoalbuminemia and postoperative BG at 24 hours were variables statistically associated with SSI and behaved as risk factors on binary and multivariate logistic regression analysis. When the administration of prophylactic antibiotics is required, should be given at induction of an aesthesia is recommended.