Determinants of Surgical Wound Infection at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
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Keywords
Surgical Wound Infections, Surgical Site Infection, Risk Factors, Determinants, General Surgery
Abstract
Background: This study determined the prevalence and associated risk factors of surgical wound infections (SWI) among adult patients who underwent general surgery at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Ethical approval for this study was obtained from the UPTH Ethics Committee.
Methodology: A retrospective cross-sectional study was conducted using medical records of 440 adult patients (≥18 years) who underwent surgery between 2018 and 2023. Data on demographics and clinical characteristics were extracted following the United States Centers for Disease Control and Prevention criteria. Chi-square tests, t-tests, and multivariable logistic regression were used to identify independent predictors of SWI.
Results: Overall SWI prevalence was 7.3% (32/440; 95% CI: 5.0-10.1%). Mean age was 41.9 (14.1) years, and 60.0% were female. All patients received postoperative antibiotic prophylaxis. Patients with SWI were younger (mean: 35.0 vs 42.8 years; p < 0.001) and had longer hospital stays (median: 11 vs 7 days; p = 0.004). In multivariable analysis, each additional year of age reduced SWI odds by 5% (adjusted OR = 0.95; 95% CI: 0.92-0.98; p = 0.004), while gender and surgery type were not significant. Assessment of comorbidities (diabetes, smoking, obesity) was precluded by incomplete documentation (60% missing) and very low documented prevalence (3-4% vs expected 10-30%). No significant temporal trend in SWI prevalence was observed from 2018 to 2023 (p = 0.43).
Conclusion: SWI prevalence at UPTH was 7.3%, with younger age identified as an independent risk factor. Improved preoperative screening and prospective surveillance with targeted preventive measures for younger surgical patients may help reduce SWI rates.
References
2. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228–41. doi:10.1016/S0140-6736(10)61458-4
3. Chukwuma ST, Balogun OS, Oduyebo OO, Oshun PO, Osuagwu CS, Rotimi VO. Prevalence of anaerobic bacteria in surgical site infections in Lagos University Teaching Hospital. J West Afr Coll Surg. 2024;14(2):166–73. doi:10.4103/jwas.jwas_91_23
4. Salako AA, Badmus TA, Onyia CU, et al. An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital. Afr Health Sci. 2019;19(2):2068–72. doi:10.4314/ahs.v19i2.30
5. Nwankwo E, Edino S. Seasonal variation and risk factors associated with surgical site infection rate in Kano, Nigeria. Turk J Med Sci. 2014;44(4):24. doi:10.3906/sag-1305-47
6. Amoran OE, Sogebi AO, Fatugase OM. Rates and risk factors associated with surgical site infections in a tertiary care center in South-Western Nigeria. Int J Trop Dis Health. 2013;3(1):25–36. doi:10.9734/IJTDH/2013/1769
7. Taiwo OD, Adeleke AO, Oluwaseyi AA. Prevalence of surgical site infection among Caesarean section patients in a teaching hospital in Ekiti State, Nigeria: An eight-year review. Sci Afr. 2022;16:e01216. doi:10.1016/j.sciaf.2022.e01216
8. Whiting PF, Davenport C, Jameson C, et al. How well do health professionals interpret diagnostic information? A systematic review. BMJ Open. 2015;5(7):e008155. doi:10.1136/bmjopen-2015-008155
9. Olowo-Okere A, Ibrahim YKE, Olayinka BO, Ehinmidu JO. Epidemiology of surgical site infections in Nigeria: A systematic review and meta-analysis. Niger Postgrad Med J. 2019;26(3):143–51. doi:10.4103/npmj.npmj_72_19
10. Lowe H, Woodd S, Lange IL, Janjanin S, Barnet J, Graham W. Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: A qualitative study. Confl Health. 2021;15(1):94. doi:10.1186/s13031-021-00428-8
11. Dodiyi-Manuel A, Dodiyi-Manuel SA. Surgical site infection in a tertiary center in Nigeria. IOSR J Dent Med Sci. 2017;16(3):8–11.
12. Papadopoulos A, Machairas N, Tsourouflis G, et al. Risk factors for surgical site infections in patients undergoing emergency surgery: A single-centre experience. In Vivo. 2021;35(6):3569–74. doi:10.21873/invivo.12660
13. Jadoon SK, Khan RMI, Khan TA, Akhtar N, Qayyum Y, Kumar K, et al. Comparative study of wound infection between elective and emergency abdominal surgeries: A retrospective cohort study. Ann Med Surg (Lond). 2023;85(5):1490–5. doi:10.1097/MS9.0000000000000549
14. Bischoff P, Kramer TS, Schröder C, Behnke M, Schwab F, Geffers C, et al. Age as a risk factor for surgical site infections: German surveillance data on total hip replacement and total knee replacement procedures (2009 to 2018). Euro Surveill. 2023;28(9):2200535. doi:10.2807/1560-7917.ES.2023.28.9.2200535
15. Aghdassi SJS, Schröder C, Gastmeier P. Gender-related risk factors for surgical site infections: Results from 10 years of surveillance in Germany. Antimicrob Resist Infect Control. 2019;8:95. doi:10.1186/s13756-019-0547-x
16. Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013;8(12):e83743. doi:10.1371/journal.pone.0083743
17. Jiang C, Chen Q, Xie M. Smoking increases the risk of infectious diseases: A narrative review. Tob Induc Dis. 2020;18:60. doi:10.18332/tid/123845
18. Qiao Y, Zhang T, Bai T, Peng X, Lin H, Zhang A. Effect of body mass index on surgical site wound infection, mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer: A meta-analysis. Int Wound J. 2023;20(1):164–72. doi:10.1111/iwj.13860
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