FREQUENCY OF SURGICAL SITE INFECTION POST DECORTICATION

Abstract

Background: Surgical site infections (SSIs) are among the most frequent and preventable postoperative complications, accounting for significant morbidity, prolonged hospitalization, and financial burden. Although SSIs have been extensively studied in various surgical fields, limited data are available on their incidence, causative organisms, and contributing factors following open lung decortication for empyema, especially in low-resource healthcare settings. Addressing this knowledge gap is crucial for tailoring effective infection prevention and management protocols.

Objective: To determine the frequency, microbial etiology, and associated risk factors of surgical site infections in patients undergoing open lung decortication for empyema.

Methods: A descriptive study was carried out over six months in the Department of Thoracic Surgery, Lady Reading Hospital, Peshawar. A total of 139 patients aged ≥18 years who underwent open decortication were included using non-probability consecutive sampling. Patients with immunosuppression, diabetes, chronic kidney disease, pre-existing skin infections, or re-do procedures were excluded. Data were collected through a pretested structured proforma, and SSI was diagnosed during 2–3 week postoperative follow-up based on clinical signs, wound culture reports, and surgeon’s assessment. Microbial isolates were identified using standard culture and sensitivity techniques. Data were analyzed using SPSS version 29, with p ≤ 0.05 considered statistically significant.

Results: Of the 139 patients, 80 (57.5%) were male and 59 (42.5%) were female, with a mean age of 34.6 ± 4.2 years. The mean hospital stay was 8.2 ± 2.4 days. SSIs were identified in 15 patients (10.79%); 8 (53.3%) were superficial, 5 (33.3%) deep, and 2 (13.3%) organ-space infections. Microorganisms were isolated in 13 (86.6%) cases, with Pseudomonas aeruginosa being the most common (30.7%), followed by Acinetobacter spp. and Staphylococcus aureus (each 15.38%). Univariate analysis showed no significant association between SSI and age, gender, or hospital stay (p > 0.05).

Conclusion: The incidence of SSIs after open lung decortication was moderately high, with a predominance of superficial infections and delayed presentation after discharge. The high prevalence of nosocomial organisms emphasizes the need for improved infection control, targeted empirical antibiotic therapy, and enhanced post-discharge follow-up.