JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields.

eISSN: 2980-0862
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Rate and risk factors of surgical site infection following abdominal surgery; a prospective study
Abstract
Aims: Surgical site infection (SSI) remains a significant cause of morbidity and financial burden on patients. This study aimed to describe the incidence and risk factors associated with developing SSI in adult patients after abdominal surgery.
Methods: In this 6-month prospective observational study, adult patients undergoing abdominal surgery at the Gastrointestinal Surgery Unit of our tertiary referral center were included. Excluded from the study were patients lost to follow-up, those undergoing, urological, vascular, plastic, or transplant surgeries. Patients were followed up for 30 days, data collection was done using a standardized data collection form, and SSI was diagnosed according to the Centers for Disease Control and Prevention definition. Univariate and multivariate analyses were performed to identify risk factors for SSI.
Results: The study included a total of 212 patients. The incidence of SSI was 32.5%. Emergency operations, male gender, and high body mass index were identified as independent predictors of SSI. The most commonly isolated organisms in analyzed cultures were Klebsiella spp.
Conclusion: A high rate of SSI following abdominal surgery was observed. Periodic audits to assess compliance with established standard infection control measures, review of prophylactic antibiotic guidelines, as well as addressing modifiable risk factors have the prospect of reducing SSI.

Keywords : Surgical site infection, abdominal surgery, risk factors, antibiotic resistance

Download Article


1. European Centre for Disease Prevention and Control. Annual Epidemiological Report 2016: Surgical Site Infections. European Centre for Disease Prevention and Control; 2016. Accessed June 28, 2023. https://www.ecdc.europa.eu/en/publications-data/surgical-site-infections-annual-epidemiological-report-2016-2014-data
2. Abduo EM, El-Kholy J, Abdou S, Hafez S, Omar N, Talaat M. Incidence and microbial etiology of surgical site infections at select hospitals in Egypt. Am J Infect Control. 2016;44(6 suppl):S52-S53. doi:10.1016/j.ajic. 2016.04.049
3. Alkaaki A, Al-Radi OO, Khoja A, et al. Surgical site infection following abdominal surgery: a prospective cohort study. Can J Surg. 2019;62(2): 111-117. doi:10.1503/cjs.004818
4. GlobalSurg Collaborative. Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis. 2018;18(5):516-525. doi:10.1016/S1473-3099(18)30101-4
5. Cui M, Zhai D, Liu Y, et al. Case report: primary mediastinal Ewing’s sarcoma presenting with chest tightness. Front Oncol. 2023;12:1020339. doi:10.3389/fonc.2022.1020339
6. Carvalho RLR, Campos CC, Franco LMC, Rocha AM, Ercole FF. Incidence and risk factors for surgical site infection in general surgeries. Rev Lat Am Enfermagem. 2017;25:e2848. doi:10.1590/1518-8345.1502. 2848
7. Onyekwelu I, Yakkanti R, Protzer L, Pinkston CM, Tucker C, Seligson D. Surgical wound classification and surgical site infections in the orthopaedic patient. J Am Acad Orthop Surg Glob Res Rev. 2017;1(3):e022. doi:10.5435/JAAOSGlobal-D-17-00022
8. Badia JM, Casey AL, Petrosillo N, Hudson PM, Mitchell SA, Crosby C. Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. J Hosp Infect. 2017;96(1):1-15. doi:10.1016/j.jhin.2017.03.004
9. Abu-Sheasha GA, Yassine OG, Anwar MM, Bedwani RN. Cost of surgical site infection in Egyptian University Hospital: informing a decision to implement an infection control program using simulation. Oper Res Health Care. 2018;18:26-32. doi:10.1016/j.orhc.2017.11.001
10. Friedman ND, Bull AL, Russo PL, Gurrin L, Richards M. Performance of the National Nosocomial Infections Surveillance risk index in predicting surgical site infection in Australia. Infect Control Hosp Epidemiol. 2007;28(1):55-59. doi:10.1086/509848
11. Sangsuwan T, Jamulitrat S, Watcharasin P. Risk adjustment performance between NNIS index and NHSN model for postoperative colorectal surgical site infection: a retrospective cohort study. Ann Med Surg (Lond). 2022;77:103715. doi:10.1016/j.amsu.2022.103715
12. Barie PS. Surgical infections and antibiotic use. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: the Biological Basis of Modern Surgical Practice. 20th ed. Elsevier; 2017:241-280.
13. Singh VP, Khan S. Performance of National Nosocomial Infection Surveillance System (NNIS) risk index in predicting surgical site infections. Int J Sci Res. 2016;5(9):311-314.
14. Baro AC, Anoop R, Rongpi R, Barua P. Incidence of surgical site infection in abdominal surgery in a tertiaty care center in Assam. Int J Adv Res. 2022;10(3):835-840. doi:10.21474/IJAR01/14458
15. Save M, Khadilkar R, Shah P, Shiva R. A study of incidence and factors determining the occurrence of surgical site infection in abdominal surgeries. Int Surg J. 2020;7(2):520-525. doi:10.18203/2349-2902.isj20200308
16. Mofikoya BO, Neimogha MI, Ogunsola FT, Atoyebi OA. Bacterial agents of abdominal surgical site infections in Lagos Nigeria. Eur J Sci Res. 2009;38(3):509-513.
17. Bediako-Bowan AAA, Mølbak K, Kurtzhals JAL, Owusu E, Debrah S, Newman MJ. Risk factors for surgical site infections in abdominal surgeries in Ghana: emphasis on the impact of operating rooms door openings. Epidemiol Infect. 2020;148:e147. doi:10.1017/S0950268820001454
18. Kamat US, Ferreira AMA, Kulkarni MS, Motghare DD. A prospective study of surgical site infections in a teaching hospital in Goa. Indian J Surg. 2008;70(3):120-124. doi:10.1007/s12262-008-0031-y
19. Deyem KK, Fabrice LM, Medard KK, Claude KM, Munyali A. Risk factors and predictive model for surgical site infections after abdominal surgery at HEAL Africa Tertiary Hospital in Goma, Democratic Republic of Congo. East Cent Afr J Surg. 2025;30(4):20-29. doi:10.4314/ecajs.v30i4.3
20. Ghanem AM, Abou-Ali M, Hussein AH, Anwar AM, Abu-Elela ST. Evaluation of the outcome of the use of 2% lidocaine irrigation in the prevention of abdominal surgical site infection. Suez Canal Univ Med J. 2021;24(1):29-40.
21. Aga E, Keinan-Boker L, Eithan A, Mais T, Rabinovich A, Nassar F. Surgical site infections after abdominal surgery: incidence and risk factors. A prospective cohort study. Infect Dis (Lond). 2015;47(11):761-767. doi:10.3109/23744235.2015.1055587
22. Morikane K. Epidemiology and risk factors associated with surgical site infection after different types of hepatobiliary and pancreatic surgery. Surg Today. 2017;47(10):1208-1214. doi:10.1007/s00595-017-1503-0
23. Watanabe A, Kohnoe S, Shimabukuro R, et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today. 2008;38(5):404-412. doi:10.1007/s00595-007-3637-y
24. Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV. Obesity and the risk for surgical site infection in abdominal surgery. Am Surg. 2016;82(4):331-336. doi:10.1177/000313481608200418
25. Rawabdeh AAA, Al Mulhim ARS, Khan ZU. Surgical site infections incidence, their predictors and causative organisms in a teaching hospital. Int J Community Fam Med. 2016;1:104. doi:10.15344/2456-3498/2016/104
26. Watanabe M, Suzuki H, Nomura S, et al. Risk factors for surgical site infection in emergency colorectal surgery: a retrospective analysis. Surg Infect (Larchmt). 2014;15(3):256-261. doi:10.1089/sur.2012.154
27. Zwicky SN, Gloor S, Tschan F, et al. No impact of sex on surgical site infections in abdominal surgery: a multi-center study. Langenbecks Arch Surg. 2022;407(8):3763-3769. doi:10.1007/s00423-022-02691-6
28. Cheadle WG. Risk factors for surgical site infection. Surg Infect (Larchmt). 2006;7(suppl 1):S7-S11. doi:10.1089/sur.2006.7.s1-7
29. Korol E, Johnston K, Waser N, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013;8(12):e83743. doi:10.1371/journal.pone.0083743
30. Scilletta R, Pagano D, Spada M, et al. Comparative analysis of the incidence of surgical site infections in patients with liver resection for colorectal hepatic metastases after neoadjuvant chemotherapy. J Surg Res. 2014;188(1):183-189. doi:10.1016/j.jss.2013.11.1092
31. Afifi IK, Labah EA, Ayad KM. Surgical site infections after elective general surgery in Tanta University Hospital: rate, risk factors and microbiological profile. Egypt J Med Microbiol. 2009;18(2):61-72.
32. Mokhtar SM, Harb SE, Hathout MS, Hussein AM. Surgical site infection: a study of incidence, risk factors and causative organisms in emergency abdominal surgeries in Kasr Al-Ainy Hospital. Kasr El Aini J Surg. 2016;17(3):119.
33. Labib NA, El-Lawindi M, Abdelaziz SB, Abdelwahab MG, Abdelhamid YS. Incidence and predictors of surgical site infections at Cairo University Hospitals. Egypt J Community Med. 2012;30(1):39-58.
34. Kueht M, Bebko S, Helmick R, Awad S. Hepatitis C status and infectious complications in the surgical intensive care unit: a retrospective analysis of 1,941 consecutive patients. Am J Surg. 2016;211(6):1064-1070. doi:10. 1016/j.amjsurg.2015.07.033
35. Raouf M, Ghazal T, Kassem M, Agamya A, Amer A. Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt. J Infect Dev Ctries. 2020;14(3):277-283. doi:10.3855/jidc.12124
36. Hafez S, Saied T, Hasan E, et al. Incidence and modifiable risk factors of surveillance of surgical site infections in Egypt: a prospective study. Am J Infect Control. 2012;40(5):426-430. doi:10.1016/j.ajic.2011.07.001
37. Ott E, Bange FC, Sohr D, Teebken O, Mattner F. Risk factors associated with surgical site infections following vascular surgery at a German university hospital. Epidemiol Infect. 2013;141(6):1207-1213. doi:10.1017/S095026881200180X
38. Adejumo AA, Nuhu M, Afolaranmi T. Incidence of and risk factors for abdominal surgical site infection in a Nigerian tertiary care centre. Int J Infect Control. 2015;11(4). doi:10.3396/IJIC.v11i4.027.15
39. Cheuk N, Worth LJ, Tatoulis J, Skillington P, Kyi M, Fourlanos S. The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care. J Hosp Infect. 2021;116:47-52. doi:10.1016/j.jhin.2021.07.009
40. Mawalla B, Mshana SE, Chalya PL, Imirzalioglu C, Mahalu W. Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011;11:21. doi:10.1186/1471-2482-11-21
41. Sugiura T, Uesaka K, Ohmagari N, Kanemoto H, Mizuno T. Risk factor of surgical site infection after pancreaticoduodenectomy. World J Surg. 2012;36(12):2888-2894. doi:10.1007/s00268-012-1742-6
42. Foschi D, Yakushkina A, Cammarata F, et al. Surgical site infections caused by multi-drug resistant organisms: a case-control study in general surgery. Updates Surg. 2022;74(5):1763-1771. doi:10.1007/s13304-022-01243-3
43. Muhamad AN, Teh CSJ, Draman MR, et al. High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023. Antimicrob Resist Infect Control. 2025;14(1):22. doi:10.1186/s13756-025-01537-2
Article available in :
Volume 4, Issue 3, 2026
Page : 54-60
https://doi.org/10.51271/JOCS-0077
Article Information
Received : 06 May 2026
Accepted : 30 Haz 2026
Published : 25 Ağu 2026
Corresponding Author :

Hassan Isah Abubakar: Department of Surgery, Federal Medical Centre Keffi, Nasarawa, Nigeria

[email protected]
Citation : Elkeleny MR, Abubakar MI, Ghazal AA, Mourad M. Rate and risk factors of surgical site infection following abdominal surgery; a prospective study. J Compr Surg. 2025;4(3):54-60.

Read: 4
Download : 7
Cited: 0
_Footer