Direct observation surveillance of surgical site infections among paediatric surgical patients at a tertiary institution in Nigeria: A prospective epidemiologic study

Abstract

Background: Surgical site infection (SSI) is a cause of significant morbidity following surgery and it sometimes results in mortality. Few studies from West Africa have documented their experience in children. The aim of this study was to establish baseline data and determine the effect of duration of preoperative surgical hand scrubbing on the occurrence of SSI.

Methods: A prospective, direct observational surveillance was performed on all patients who had surgeries in our unit over an eight-month period between August 2012 and March 2013. SSI was diagnosed and classified using the CDC criteria. Data was analyzed using Epi Info version 7. Chi square test was used to compare categorical variables and a p value of 0.05 was considered significant.

Results: One hundred and ninety two patients were recruited into the study. There were 67 (34.9%) incisions classified as clean, 80 (41.7%) as clean contaminated, 30 (15.6%) as contaminated and 15 (7.8%) as dirty. The prevalence rate of SSI was 8.3%. The SSI rates per wound class were: Clean – 3.0%; Clean contaminated – 6.3%, Contaminated – 16.7% and Dirty – 26.7%. Occurrence of SSI correlates with class of incision (p=0.006) but not with duration of surgeon (p=0.5415) or assistant surgeon hand scrub (p= 0.5193).

Conclusion: The SSI rate in our centre is high and the duration of hand scrub does not impact on its occurrence.