Surgical Site Infections in a Rehabilitation Hospital-Pattern and Types

Abstract

Background: Surgical-site infection(SSI) is a major problem worldwide and is associated with significant morbidity, increase length of hospital stay and cost.
Objective: To determine incidence and risk factors for surgical-site infections after orthopaedic operations.
Methods: Five months prospective surveillance of surgicalsite infections was conducted at NKST Rehabilitation Hospital ,Mkar from 1st June 2010 to 30th October 2010. All the patients who underwent orthopaedic operation were evaluated. Patients who had completed cast(POP) application postoperatively were excluded from the study(inspection of woundcould not be possible). Wounds were inspected and scored five times within 14 days by the authors using scoring method designed by Wilson et al.
Results: A total of one hundred and twenty eight orthopaedic operations were performed in our centre. Seventy nine patients(61.7%) were male and 49(38.3%) female . The age of patients ranged from 4 to 80years with mean age of 34.7years. Eighty one(63.3%) of the wound were classified as clean, 17(13.3%) as contaminated and 23(23.4%)as dirty. Sixty eight (53.1%) cases showed satisfactory healing, 26(20.3%) had disturbance of healing and 15 (11.7%), 12(9.4%) and 7(5.5%) had minor, moderate and severe wound infection respectively. The incidence of surgical site infections in clean cases was 3.4%, 55.6% in contaminated cases and 70% when the wound was classified as dirty. The overall incidence rate of surgical site infections was 24.3%.
Conclusion: surgical-site infection is a major problem in orthopaedics operations. Prevention of surgical-site infection should be emphasized and intervention methods should aim at modifying the risk factors.

Keywords: Surgical-site, infection, orthopaedic operations.