Relevance of Subcutaneous Fat Thickness as a Risk Factor for Surgical Site Infections in Abdominal Surgeries.

Abstract

IntroductionIncisional surgical site infection is an important cause of postoperative morbidity which results in extended hospital stay and may result in future incisional hernia. We intended to evaluate the thickness of subcutaneous fat with a cut-off value of 2.5cm as a risk factor in causing surgical site infection using a simple, cost-effective, and direct intraoperative method for measuring subcutaneous fat thickness.MethodsA total of 147 patients who underwent abdominal surgeries from September 2017 to April 2019 were included in this prospective study. A proforma was used to collect information of all patients regarding various variables. Abdominal subcutaneous fat thickness was measured in the supine position intraoperatively with a measuring scale from below dermis to rectus sheath at 1cm caudal to umbilicus level.ResultsThe study's overall incidence of incisional surgical site infection (SSI) in laparotomy surgeries was 10.8%. Subcutaneous fat thickness was independently associated with incisional SSI. Subcutaneous fat thickness association with SSI was more statistically significant than that of BMI. The other associated risk factors were found to be obesity, diabetes, and emergency surgery.ConclusionOur results suggest that the risk of incisional SSI increases with the increased subcutaneous fat thickness of more than 2.5cm. Placement of subcutaneous drain in patients undergoing laparotomy with increased subcutaneous fat thickness plays a significant role in reducing the incidence of surgical site infection. Risk of SSI increases in obesity, diabetes, increased age group, dirty surgery, and emergency surgeries. Subcutaneous fat thickness is an independent risk factor for surgical site infection and subcutaneous drain decreases the risk of SSI in thick subcutaneous fat.