Surgical site infection after digestive surgery in a single tertiary hospital in Indonesia: six years of data

Authors

  • Ridho Ardhi Syaiful Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-4713-7376
  • Yarman Mazni Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Muhamad Luthfi Prasetyo Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Toar Jean Maurice Lalisang Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.13181/mji.oa.192698

Keywords:

digestive surgery, incidence, risk factors, surgical site infection

Abstract

BACKGROUND Surgical site infection (SSI) is responsible for increasing cost, morbidity, and mortality related to surgical operations, and has continued to be a significant problem even in hospitals with advanced facilities. This study aimed to describe the SSI among patients after digestive surgery.

METHODS From 2012 to 2017, all abdominal surgeries with SSI in Cipto Mangunkusumo Hospital, except obstetrics and gynecology cases, were included in the study. Demographic characteristics, nutritional status, preoperative and intraoperative conditions, wound contamination/SSI type, and mortality data were reported.

RESULTS From 4,893 abdominal surgeries during the period, 135 subjects (2.8%) developed SSI with 42.2% of cases were the clean-contaminated type. Most of the cases were males (66.7%), aged between 2565 years old (80.0%), subjective goal assessment B (46.7%), had normal weight (57.8%), had longer duration of surgery (70.4%), and had preoperative stay between 215 days (65.2%). Most of the SSI patients survived (77.8%).

CONCLUSIONS Even though the SSI in Cipto Mangunkusumo Hospital was low, it still needs improvement in preoperative care, intraoperative care, and SSI awareness. Therefore, further studies are required to understand how to reduce the incidence, risk, and SSI-related mortality.

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References

Satyanarayana V, Prashanth HV, Bhandare B, Kavyashree AN. Study of surgical site infection in abdominal surgeries. J Clin Diagn Res. 2011;5(5):935-9.

Pinkney TD, Bartlett DC, Hawkins W, Mak T, Youssef H, Futaba K, et al. Reduction of surgical site infection using a novel intervention (ROSSINI): study protocol for a randomised controlled trial. Trials. 2011;12:217. https://doi.org/10.1186/1745-6215-12-217

Castro Pde T, Carvalho AL, Peres SV, Foschini MM, Passos AD. Surgical-site infection risk in oncologic digestive surgery. Braz J Infect Dis. 2011;15(2):109-15. https://doi.org/10.1016/S1413-8670(11)70154-4

Haryanti L, Pudjiadi AH, Ifran EK, Thayeb A, Amir I, Hegar B. Prevalence and risk factors for postoperative wound infection. Sari Pediatri. 2013;15(4):207-12. Indonesian. https://doi.org/10.14238/sp15.4.2013.207-12

Young PY, Khadaroo, RG. Surgical site infection. Surg Clin North Am. 2014;94(6):1245-64. https://doi.org/10.1016/j.suc.2014.08.008

Múñez E, Ramos A, Espejo TÁ, Vaqué J, Sánchez-Payá J, Pastor V, et al. Microbiología de las infecciones del sitio quirúrgico en pacientes intervenidos del tracto digestive [Microbiology of surgical site infections in abdominal tract surgery patients]. Cir Esp. 2011;89(9):606-12. Spanish. https://doi.org/10.1016/j.ciresp.2011.05.008

Cohen B, Choi YJ, Hyman S, Furuya EY, Neidell M, Larson E. Gender differences in risk of bloodstream and surgical site infections. J Gen Intern Med. 2013;28(10):1318-25. https://doi.org/10.1007/s11606-013-2421-5

Ishikawa K, Kusumi T, Hasokawa M, Nishida Y, Sumikawa S, Furukawa H. Incisional surgical site infection after elective open surgery for colorectal cancer. Int J Surg Oncol. 2014;2014:419712. https://doi.org/10.1155/2014/419712

Fan Y, Wei Z, Wang W, Tan L, Jiang H, Tian L, et al. The incidence and distribution of surgical site infection in Mainland China: a meta-analysis of 84 prospective observational studies. Sci Rep. 2014;4:6783. https://doi.org/10.1038/srep06783

World Health Organization. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363(9403):157-63. https://doi.org/10.1016/S0140-6736(03)15268-3

Shirodkar M, Mohandas KM. Subjective global assessment: a simple and reliable screening tool for malnutrition among Indian. Indian J Gastroenterol. 2005;24:246-50.

Ouedraogo S, Kambire JL, Ouedraogo S, Ouangre E, Diallo I, Zida M, et al. Surgical site infection after digestive surgery: diagnosis and treatment in a context of limited resources. Surg Infect (Larchmt). 2020;21(6):547-51. https://doi.org/10.1089/sur.2019.007

Hennessey DB, Burke JP, Ni­Dhonochu T, Shields C, Winter DC, Mealy K. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi­institutional study. Ann Surg. 2010;252(2):325-9. https://doi.org/10.1097/SLA.0b013e3181e9819a

Meilyana F, Djais J, Garna H. Nutrition status based on subjective global assessment as a length-of-stay factor in pediatric inpatient care. Sari Pediatri. 2010;12(3);162-7. Indonesian. https://doi.org/10.14238/sp12.3.2010.162-7

Shinkawa H, Takemura S, Uenishi T, Sakae M, Ohata K, Urata Y, et al. Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy. Surg Today. 2013;43(3):276-83. https://doi.org/10.1007/s00595-012-0350-2

Dobner J, Kaser S. Body mass index and the risk of infection - from underweight to obesity. Clinical Microbiol Infect. 2018;24(1):24-8. https://doi.org/10.1016/j.cmi.2017.02.013

Hu Q, Wang G, Ren J, Ren H, Li G, Wu X, et al. Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patiens undergoing bowel resections. Medicine. 2016;95(27):e4084. https://doi.org/10.1097/MD.0000000000004084

Hu WH, Chen HH, Lee KC, Liu L, Eisenstein S, Parry L, et al. Assesment of the addition of hypoalbuminemia to ACS-NSQIP surgical risk calculator in colorectal cancer. Medicine. 2016;95(10):e2999. https://doi.org/10.1097/MD.0000000000002999

Testa M, Stillo M, Giacomelli S, Scoffone S, Argentero PA, Farina EC, et al. Appropriate use of antimicrobial prophylaxis: an observational study in 21 surgical wards. BMC Surg. 2015;15:63. https://doi.org/10.1186/s12893-015-0048-7

Loho T. Bacterial and antibiotics susceptibility profile at Cipto Mangunkusumo General Hospital Januari-June 2018. Chapter IV; p. 105-12. Indonesian.

Curcio D, Cane A, Fernández F, Correa J. Surgical site infection in elective and clean-contaminated surgeries in developing countries. International J Infect Dis. 2019;80:34-45. https://doi.org/10.1016/j.ijid.2018.12.013

Khairy GA, Kambal AM, Al-Dohayan AA, Al-Shehri MY, Zubaidi AM, Al-Naami MY, et al. Surgical site infection in a teaching hospital: a prospective study. J Taibah Univ Sci. 2011;6(2):114-20. https://doi.org/10.1016/S1658-3612(11)70172-X

Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect. 2013;14(1):73-156. https://doi.org/10.1089/sur.2013.9999

Mawalla B, Mshana SE, Chalya PL, Imirzalioglu C, Malahu W. Predictors of surgical site infection among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011;11:21. https://doi.org/10.1186/1471-2482-11-21

Shinkawa H, Takemura S, Uenishi T, Sakae M, Ohata K, Urata Y, et al. Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy. Surg Today. 2013;43(3):276-83. https://doi.org/10.1007/s00595-012-0350-2

Ban KA, Minei JP, Loronga C, Harbrecht BG, Jensen EH, Fry DE, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 Update. J Am Coll Surg. 2017;224(1):59-74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029

Published

2020-10-05

How to Cite

1.
Syaiful RA, Mazni Y, Prasetyo ML, Lalisang TJM. Surgical site infection after digestive surgery in a single tertiary hospital in Indonesia: six years of data. Med J Indones [Internet]. 2020Oct.5 [cited 2024Nov.21];29(3):310-5. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/2698

Issue

Section

Clinical Research
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