title: Incidence of surgical site infection in postoperative patients at a tertiary care centre in India.
abstract: OBJECTIVE
  A prospective observational was carried out to calculate the incidence of surgical site infections (SSI) along with the main risk factors and causative organisms in postoperative patients at a tertiary care setting in Mumbai.
  
  
  METHODS
  A total number of 1196 patients between June 2011 to March 2013 admitted to the general surgical ward or surgical ICU of our hospital were included in the study. Post laproscopy patients and organ space SSIs were excluded. Patient data were collected using a preformed pro forma and a wound Southampton score tabulated and checked repeatedly until suture removal of patient. Regular follow-up was maintained until at least 30 days postoperatively.
  
  
  RESULTS
  The study showed a SSI rate of 11%. Risk factors associated with a higher incidence of SSI were found to be age (>55 years), diabetes mellitus (especially uncontrolled sugar in the perioperative period), immunocompromised patients (mainly HIV and immunosuppressive therapy patients), surgeon skill (higher in senior professors compared with junior residents), nature of the cases, (emergency surgeries), placement of drains, wound class (highest in dirty wounds), type of closure (multilayer closure), prolonged duration of hospital stay, longer duration of surgery (>2 hours), type of surgery (highest in cholecystectomy). The highest rates of causative organisms for SSIs found were Staphylococcus aureus, Escherichia coli and Klebsiella ssp.
  
  
  CONCLUSIONS
  Prevention of SSIs requires a multipronged approach with particular emphasis on optimising preoperative issues, adhering religiously to strict protocols during the intraoperative period and addressing and optimising metabolic and nutritional status in postoperative period.
authors.affiliation: General Surgery, Senior Resident.
authors.forename: M Siddique J
authors.initials: MS
authors.lastname: Akhter
authors.affiliation: General Surgery, Professor, Head Of Unit.
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.affiliation: General Surgery, Lecturer.
authors.forename: K Premjeet
authors.initials: KP
authors.lastname: Madhukar
authors.affiliation: General Surgery, Lecturer.
authors.forename: A Rajiv
authors.initials: AR
authors.lastname: Vaishampayan
authors.affiliation: Medical Student (Intern).
authors.forename: P C
authors.initials: PC
authors.lastname: Unadkat
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D017558:Elective Surgical Procedures; D004630:Emergencies; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007194:India / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D013211:Staphylococcus aureus; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D062606:Tertiary Care Centers; D058106:Wound Closure Techniques
chemical_list: D007166:Immunosuppressive Agents
keywords: SSIs; Southampton; postoperative; site; surgical site