Chulalongkorn Medical Journal


Background : Surgical site infection (SSI), is a major problem and the mostcommon complication of surgery. It was considered an essentialindicator for a quality of care of hospital. SSI affects patients sufferfrom increasing morbidity and mortality, prolongs length of stay,delay recovery, decreases quality of life, and increases medicalcosts. Although urgent abdominal surgery is a significant treatmentfor patients with life-threatening intraabdominal conditions, it isusually associated with increased risk of SSI. Factors related toSSI need to be explored to help improve healthcare services andsurveillance program in high-risk patients.Objective : To study SSI incidence and the factors associated with SSI inpatients undergoing urgent abdominal surgery.Designs : Descriptive retrospective research design.Setting : King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Material and Method : The data was collected from the medical record. The collecteddata: age, hospital length of stay, kind of surgical procedure,the duration of surgery, comorbidity, the American Society ofAnesthesiologists physical status (ASA), Obesity, preoperativeand postoperative Systemic Inflammatory Response Syndrome(SIRS), type of surgical wound (clean, clean-contaminate,contaminate and dirty), blood transfusion, admission to intensivecare unit (ICU) after surgery, plasma glucose level, serum albuminlevel and prophylactic antibiotic. Inclusion criteria comprisedpatients who were > 16 years old and had urgent abdominalsurgery at King Chulalongkorn Memorial Hospital from January 1,2010, to December 31, 2012. Data was analyzed by using SPSSV.11.5. The relationships were tested by Chi-square, the Fisherexact test and the Odd Ratio was tested by Cochran’s andMantel-Haenzed.Result : Of 439 patients undergoing urgent abdominal surgery, 93 (21.18%)developed SSI and factors were associated with SSI (P < .05) inpatients undergoing urgen tab dominal surgery, were the AmericanSociety of Anesthesiologists physical status (ASA) and preoperativeSystemic Inflammatory Response Syndrome (SIRS), the durationof surgery, the type of wound, the use of drainage, bloodtransfusion, the admission to ICU after surgery, postoperativeplasma glucose levels, serum albumin levels, postoperativeSystemic Inflammatory Response Syndrome(SIRS) and prophylacticantibiotics.Conclusion : SSI remains a major problem and the most common complicationof surgery, factors related to SSI compare with other study, thereis different for some factors. The using result of study to monitorrisk factors and to develop the surveillance program in patientwith undergoing urgent abdominal surgery, these can improvepatients care services.


Faculty of Medicine, Chulalongkorn University

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