ASSESSMENT OF POSTOPERATIVE WOUND INFECTION IN ELECTIVE VS. EMERGENCY SURGERIES
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Keywords
Surgical site infection, emergency surgery, elective surgery, wound infection, antimicrobial resistance
Abstract
Background: Surgical site infections (SSI) represent a major healthcare challenge with significant morbidity and economic burden. Emergency surgeries are hypothesized to have higher infection rates compared to elective procedures due to suboptimal preoperative conditions and patient factors. This study aimed to assess and compare the incidence of postoperative wound infections between elective and emergency surgeries while identifying associated risk factors and evaluating clinical outcomes.
Methods: A prospective observational cohort study was conducted at Rama Medical College and Hospital, Hapur over six months. Five hundred patients (250 elective, 250 emergency) undergoing surgical procedures were enrolled using consecutive sampling. Data collection included demographic characteristics, surgical details, wound assessment, microbiological analysis, and economic parameters. Patients were followed for 30 days postoperatively using standardized CDC criteria for SSI diagnosis.
Results: Emergency surgeries demonstrated significantly higher SSI rates compared to elective procedures (16.8% vs. 7.2%, p=0.001). Emergency patients had higher ASA physical status scores, contaminated wound classifications (30.4% vs. 8.8%), and longer operative times (118.7±42.8 vs. 102.4±38.6 minutes). Staphylococcus aureus was predominant in both groups, with higher MRSA prevalence in emergency cases (44.4% vs. 20.0%). Emergency surgery SSI patients experienced longer hospital stays (12.6±4.8 vs. 8.4±3.2 days, p<0.001) and higher treatment costs (INR 48,260±12,840 vs. 34,680±8,420, p=0.002). Time to infection development was shorter in emergency cases (4.2±2.1 vs. 5.8±2.4 days).
Conclusion: Emergency surgeries carry a 2.33-fold higher risk of surgical site infections with increased severity, antimicrobial resistance, and healthcare costs. These findings emphasize the need for enhanced infection prevention protocols specifically tailored for emergency surgical procedures to improve patient outcomes and reduce healthcare burden.
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Dr. Birendra Kumar
Associate Professor, Department of General Surgery, Rama Medical College and Hospital & Research Centre, Hapur, Uttar Pradesh, India