Risk factors for surgical site infections in abdominal surgeries in Ghana: emphasis on the impact of operating rooms door openings

A A A Bediako-Bowan, K Mølbak, J A L Kurtzhals, E Owusu, S Debrah, M J Newman

Abstract

Major surgery carried out in low- and middle-income countries is associated with a high risk of surgical site infections (SSI), but knowledge is limited regarding contributory factors to such infections. This study explores factors related to patients developing an SSI in a teaching hospital in Ghana. A prospective cohort study of patients undergoing abdominal surgical procedures was conducted at Korle Bu Teaching Hospital. Patient characteristics, procedures and environmental characteristics were recorded. A 30-day daily surveillance was used to diagnose SSI, and Poisson regression analysis was used to test for association of SSI and risk factors; survival was determined by proportional hazard regression methods. We included 358 patients of which 58 (16.2%; 95% CI 12.7-20.4%) developed an SSI. The median number of door openings during an operation was 79, with 81% being unnecessary. Door openings greater than 100 during an operation (P = 0.028) significantly increased a patient's risk of developing an SSI. Such patients tended to have an elevated mortality risk (hazard ratio 2.67; 95% CI 0.75-9.45, P = 0.128). We conclude that changing behaviour and practices in operating rooms is a key strategy to reduce SSI risk.

OriginalsprogEngelsk
TidsskriftEpidemiology and Infection
Vol/bind148
Sider (fra-til)e147
ISSN0950-2688
DOI
StatusUdgivet - 1 jul. 2020

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