Occurrence of surgical site infection and adherence to chemoprophylaxis protocol in orthopaedics at Univerity Teaching Hospital of Kigali, Rwanda

Abstract

Background: Surgical Site Infections (SSIs) are among preventable but devastating complications in trauma and orthopaedic surgery. This study was conducted to determine the prevalence of SSIs and assess adherence to antibiotic prophylaxis protocol in the Trauma and Orthopaedic Unit at the University Teaching Hospital of Kigali (CHUK).
Objective: To assess how the orthopaedic practice at University Teaching Hospital of Kigali (CHUK) adheres to the standard protocols of antibiotic prophylaxis and to what extent the orthopaedic SSI occurs at CHUK.
Design: This was a retrospective study.
Methods: Patients who underwent any major trauma or orthopaedic procedure from 1st October 2015 to 31st December 2015 were included. The patient’s clinical records were reviewed to analyze the perioperative antibiotic use and track infectious complications within 90 days post-surgery. Percentages, means and ranges were used to describe the general characteristics and the outcome of interest.
Results: One hundred and thirty two patients with the mean age of 34.9 years were included in the study. Males accounted for 62.8% with a male to female ratio of 1.8/1. Emergencies and elective cases were accounting respectively for 90.1% and 9.8%. SSIs occurred in eight patients accounting for 6.06%. Ceftriaxone was predominantly used at 60.6% of all cases. The recommended chemoprophylaxis
administration interval of 60 to 30 minutes prior to skin incision was respected in only 31.7% of cases. A single dose of chemoprophylaxis was given in 89.4% of cases.
Conclusion: The study noted significant deviations from internationally accepted standards of SSI chemoprophylaxis. Therefore, CHUK would be recommended to develop and implement evidencebased protocols for antibiotic prophylaxis in trauma and orthopaedics, to minimize SSI and ensure antibiotic stewardship.

Key words: Surgical site infection, Chemoprophylaxis, Prophylactic measures, Perioperative, Standard protocol