SURGICAL SITE INFECTIONS IN LOW-RESOURCE SETTINGS: A FOCUSED STUDY ON THE INCIDENCE, CONTRIBUTING FACTORS, AND PREVENTION STRATEGIES FOR SURGICAL SITE INFECTIONS IN A RESOURCE-CONSTRAINED ENVIRONMENT

Abstract

Background: Surgical Site Infections (SSIs) are a significant concern in healthcare, particularly in low-resource settings, where they contribute disproportionately to postoperative morbidity and mortality. These infections arise from systemic, procedural, and patient-related factors, with limited access to infection prevention resources exacerbating the issue. Addressing these challenges is essential to improving surgical outcomes and ensuring safer care in resource-constrained environments. This study aimed to explore the incidence, contributing factors, and prevention strategies for SSIs in a low-resource setting.

Objective: To assess the incidence, contributing factors, and prevention strategies for surgical site infections in a resource-constrained environment.

Methods: This descriptive observational study was conducted at Bolan Medical College, Quetta, from August to October 2024. Data were collected from 138 patients undergoing surgical procedures, excluding those with pre-existing infections or minor outpatient procedures. Patient demographics, comorbidities, nutritional status, surgical details, and infection control practices were recorded. SSIs were classified based on the CDC criteria and monitored for 30 days postoperatively through in-person evaluations and telephone follow-ups. Statistical analysis using SPSS v26 included descriptive statistics and logistic regression to identify associations between risk factors and SSI incidence.

Results: The average patient age was 45.3 ± 12.7 years, with 75 males and 63 females. Comorbidities included diabetes (29%) and malnutrition (25%). SSIs occurred in 21.7% of patients, with superficial infections being most common (53.3%), followed by deep (33.3%) and organ/space infections (13.3%). Malnutrition had the highest SSI rate (40%), followed by diabetes (35%) and age over 50 years (30%). Procedure-related factors, such as surgery duration over 3 hours and emergency procedures, showed SSI rates of 35% and 28%, respectively. Contaminated and dirty wounds had SSI rates of 40% and 50%, respectively. Proper wound care and prophylactic antibiotics reduced SSI rates to 12% and 15%, respectively.

Conclusion: SSIs pose a significant burden in low-resource settings due to systemic, procedural, and patient-related factors. Targeted interventions, such as improving infection prevention practices, healthcare infrastructure, and patient education, are critical to reducing SSI rates and enhancing surgical outcomes in resource-constrained environments.