Incidence of surgical site infections after emergency laparotomy for perforation peritonitis

Abstract

Background: Generalized peritonitis as a result of gastrointestinal perforation is a common surgical emergency and one of important morbidity is surgical site infection (SSI). Objectives: to evaluate the incidence of SSI after emergency laparotomy for perforation peritonitis. Methodology: A prospective interventional study was conducted in the Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet from December 2019 to November 2020. Ninety patients who underwent emergency laparotomy for perforation peritonitis aged 18 years or above were included. After laparotomy standard closure technique was applied in all cases and subcutaneous closed suction drain was given in 43 cases. Results: The mean age of the patients was 32.59 ± 11.88 years, 58.9% of patients were in 21-40 years and male preponderance (66.7%). Peritonitis was most commonly due to peptic ulcer perforation (38.7%) followed by burst appendix (27.8%). Incidence of SSI was 26.7%. Subcutaneous closed suction drain was used in 47.8% of cases and its use reduced the incidence of SSI [OR=0.344 (95% CI=0.126-0.937) χ2=4.543; p=0.033]. Conclusion: Perforation peritonitis is associated with higher incidence of SSI and subcutaneous closed suction drain is effective in reducing the chances of SSI.