Post Operative Surgical Site Infection: A Narrative Review

Abstract

Background: Surgical Site Infections (SSIs) are a critical concern in postoperative care, significantly affecting patient outcomes and healthcare resources globally. These infections arise from the proliferation of microorganisms at the site of surgical intervention and are classified into early-onset (within 30 days of surgery) and late-onset (occurring more than 30 days post-surgery). Objective: This review aims to comprehensively analyze the prevalence, risk factors, and broader impact of SSIs, with an emphasis on the disparity between high-income and low- and middle-income countries (LMICs). Methods: An extensive literature review was conducted using databases such as Google Scholar and PubMed. The focus was on studies that detailed the incidence, risk factors, and prevention strategies of SSIs. Results: The review highlights a notably higher incidence of SSIs in LMICs compared to high-income countries. SSIs are a predominant cause of healthcare-associated infections (HCAIs) and are more frequently observed in emergency surgeries than elective procedures. Prominent risk factors identified include patient's age, type of surgery, specific microbial agents, blood transfusions, and comorbid conditions. Diabetes mellitus, reduced postoperative hematocrit levels, significant weight loss within six months prior to surgery, and ascites are strongly associated with an increased risk of SSI. In contrast, tobacco use, steroid use, and chronic obstructive pulmonary disease (COPD) were not found to be significant predictors. The role of surgical departments in reducing SSI occurrence through stringent antimicrobial protocols and thorough preoperative evaluations is also highlighted. Conclusion: SSIs present a significant challenge in global health, particularly in LMICs. Effective management of SSIs necessitates a multifaceted approach, incorporating improved infection control practices, individualized patient risk assessments, and international initiatives to reduce disparities. This review calls for increased awareness and targeted strategies to minimize the prevalence and impact of SSIs.