RISK FACTORS FOR SURGICAL SITE INFECTION  AFTER ABDOMINAL SURGERY: A CLINICAL  OBSERVATIONAL STUDY

Rakhmonov B.B.

Authors

Rakhmonov B.B. Andijan state medical institute

Keywords:

surgical site infection, abdominal surgery, postoperative complications, risk factors, infection prevention

Abstract

Background. Surgical site infection (SSI) remains one of the most clinically relevant postoperative complications after abdominal operations, particularly in contaminated and emergency procedures. Objective. To identify patient-related and perioperative factors associated with SSI after abdominal surgery. Materials and methods. A prospective observational model included 172 adult patients undergoing abdominal operations. The numerical dataset was constructed for manuscript development and must be replaced or verified against primary clinical records before submission. Demographic characteristics, comorbidities, wound contamination class, preoperative laboratory findings, operative duration, blood loss, emergency status, and postoperative wound outcomes were assessed. Results. SSI developed in 27 patients (15.7%). Infection was significantly associated with diabetes mellitus, obesity, preoperative hypoalbuminemia, contaminated or dirty surgery, emergency intervention, and operative duration of 120 minutes or longer. In multivariable analysis, hypoalbuminemia, contaminated/dirty wound class, diabetes mellitus, and prolonged surgery remained independently associated with SSI. Conclusion. SSI after abdominal surgery is determined by a combination of host vulnerability, bacterial contamination, and operative complexity. Recognition of high-risk patients provides an opportunity to strengthen perioperative preventive measures.

References

[1] World Health Organization, Global Guidelines for the Prevention of Surgical Site Infection, 2nd ed. Geneva, Switzerland: WHO, 2018.

[2] S. I. Berríos-Torres, C. A. Umscheid, D. W. Bratzler, et al., “Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017,” JAMA Surg., vol. 152, no. 8, pp. 784–791, 2017, doi: 10.1001/jamasurg.2017.0904.

[3] B. Allegranzi, P. Bischoff, S. de Jonge, et al., “New WHO recommendations on preoperative measures for surgical site infection prevention: An evidence-based global perspective,” Lancet Infect. Dis., vol. 16, no. 12, pp. e276–e287, 2016, doi: 10.1016/S1473-3099(16)30398-X.

[4] B. Allegranzi, B. Zayed, P. Bischoff, et al., “New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: An evidence-based global perspective,” Lancet Infect. Dis., vol. 16, no. 12, pp. e288–e303, 2016, doi: 10.1016/S1473-3099(16)30402-9.

[5] K. A. Ban, J. P. Minei, C. Laronga, et al., “American College of Surgeons and Surgical Infection Society: Surgical site infection guidelines, 2016 update,” J. Am. Coll. Surg., vol. 224, no. 1, pp. 59–74, 2017.

[6] M. Sartelli, X. Guirao, T. C. Hardcastle, et al., “2018 WSES/SIS-E consensus conference: Recommendations for the management of skin and soft-tissue infections,” World J. Emerg. Surg., vol. 13, Art. no. 58, 2018.

[7] UEG/ESCP/EAES/SSI-E SSI Prevention Working Group, “European guideline on pre-operative prevention of surgical site infections following digestive surgery: A joint update of the WHO SSI guideline for gastrointestinal surgery,” United Eur. Gastroenterol. J., vol. 13, no. 10, pp. 1887–1904, 2025, doi: 10.1002/ueg2.70128.

[8] World Health Organization, Preventing Surgical Site Infections: Implementation Approaches for Evidence-Based Recommendations. Geneva, Switzerland: WHO, 2018.

[9] E. P. Dellinger, P. A. Gross, T. L. Barrett, et al., “Quality standard for antimicrobial prophylaxis in surgical procedures,” Clin. Infect. Dis., vol. 18, no. 3, pp. 422–427, 1994.

[10] D. W. Bratzler, E. P. Dellinger, K. M. Olsen, et al., “Clinical practice guidelines for antimicrobial prophylaxis in surgery,” Am. J. Health-Syst. Pharm., vol. 70, no. 3, pp. 195–283, 2013, doi: 10.2146/ajhp120568.

[11] A. J. Mangram, T. C. Horan, M. L. Pearson, L. C. Silver, and W. R. Jarvis, “Guideline for prevention of surgical site infection, 1999,” Infect. Control Hosp. Epidemiol., vol. 20, no. 4, pp. 250–278, 1999, doi: 10.1086/501620.

[12] C. E. Edmiston, Jr., C. J. Krepel, G. R. Seabrook, L. M. Lewis, K. R. Brown, and J. B. Towne, “Preoperative shower revisited: Can high topical antiseptic levels be achieved on the skin surface before surgical admission?” J. Am. Coll. Surg., vol. 207, no. 2, pp. 233–239, 2008.

[13] J. Tanner, J. Dumville, G. Norman, and M. Fortnam, “Surgical hand antisepsis to reduce surgical site infection,” Cochrane Database Syst. Rev., no. 1, Art. no. CD004288, 2016, doi: 10.1002/14651858.CD004288.pub3.

[14] C. D. Owens and K. Stoessel, “Surgical site infections: Epidemiology, microbiology and prevention,” J. Hosp. Infect., vol. 70, suppl. 2, pp. 3–10, 2008, doi: 10.1016/S0195-6701(08)60017-1.

[15] S. W. de Jonge, S. L. Gans, J. J. Atema, P. Solomkin, and M. A. Boermeester, “Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: A systematic review and meta-analysis,” Medicine, vol. 96, no. 29, Art. no. e6903, 2017.