Determinants of superficial surgical site infections in abdominal surgeries at a Rural Teaching Hospital in Central India: A prospective study

INTRODUCTION: Abdominal surgeries have high rate of surgical site infection (SSI), which leads to significant morbidity and financial burden. There is paucity of studies on SSI in rural Indian setup, where there is scarcity of adequate resources. The aim of this study was to determine the incidence and determinants of SSI after abdominal surgeries in a rural setup. AIM: To determine the incidence of and associated risk factors for superficial SSIs in abdominal surgery cases at a central Indian rural teaching hospital. METHODS: This cohort study included 100 patients undergoing abdominal surgery between April 2016 and May 2017 at a central Indian rural teaching hospital. The outcome of interest was superficial SSI and the factors associated with it. Association between risk factors and SSI was calculated using either Chi-square test or odds ratio with 95% CI. RESULTS: The cumulative incidence rate of superficial SSI was 39% with 95% CI (29.4%–49.2%). The analysis defined 12 variables significantly associated with superficial SSI: middle or elderly age, male gender, diabetes mellitus, preoperative anemia, preoperative hypoalbuminemia, tobacco smoking, higher ASA score, perioperative blood transfusion, drain placement, surgery duration >2 h, contaminated/dirty wound class and emergency surgery. However, economic status and BMI grade of the study subjects were not associated with development of superficial SSI.