Surgical Site Infection in Abdominal Procedures: An Update on Prevention and Clinical Approach

Abstract

A surgical site infection is an infection occurring within 30 days of the procedure. They are common postoperative complications that can cause significant patient morbidity and mortality. SSIs occur in 2% to 4% of all patients undergoing inpatient surgical procedures. They constitute the second most common type of healthcare-associated infection after urinary tract infections. The etiology of the infection is multifactorial, with both patient-related and surgical-related factors playing a role. Patient-related factors include advanced age, immunocompromised status, obesity, diabetes mellitus, smoking, and poor nutritional status. Surgical-related factors include prolonged operative time, contaminated surgical instruments or equipment, poor surgical technique, and inadequate wound care. Common symptoms of SSI involve surgical site erythema, delayed healing, fever, pain, tenderness, or swelling. The diagnosis is commonly based on evidenced purulent discharge from superficial and deep wounds, organisms isolated from cultures. Overall, the management of surgical site infections includes wound care, antimicrobial therapy, wound exploration, and debridement. In addition, effective infection prevention strategies, including appropriate antimicrobial prophylaxis and adherence to infection prevention practices, are crucial in reducing the incidence of SSIs in surgical patients. This article provides a broad overview of the clinical approach to this day-to-day condition.