Incidence of surgical site infection following elective vs emergency laparotomy surgeries, the microorganisms isolated and their sensitivity pattern: A prospective, comparative, observational, single center study

Abstract

Background: Surgical site infections (SSIs) remain a significant challenge in surgical practice despite advances in infection control. This study aimed to compare the incidence of SSIs between emergency and elective laparotomy surgeries and identify the predominant microorganisms and their antibiotic sensitivity patterns. Methods: This prospective, comparative, observational single-center study was conducted at DY Patil Hospital, Mumbai from June 2022 to June 2024. A total of 90 patients (45 emergency and 45 elective laparotomies) were included. Patient demographics, laboratory parameters, type of surgery, wound contamination, and surgical site infections were documented. Microbiological assessment of wound discharge was performed with culture and sensitivity testing. Data were analyzed using a two-sample mean test and two-way ANOVA. Results: The incidence of SSI was significantly higher in emergency laparotomies (62%) compared to elective surgeries (30%). The mean age was 44.12±19.36 years in the emergency group and 47.20±15.54 years in the elective group. Contamination was found in 90% of emergency cases versus 36% of elective cases. The commonly isolated microorganisms included Escherichia coli (22.58% in emergency vs. 20% in elective), Klebsiella pneumoniae (19.35% vs. 26.7%), and Pseudomonas (3.23% vs. 13.3%). Serous discharge was the most common type (58.06% in emergency vs. 22.58% in elective cases). Antibiotic upgradation based on sensitivity was required in 51.61% of emergency and 38.71% of elective cases. Conclusion: Emergency laparotomies had a significantly higher incidence of SSIs compared to elective surgeries, likely due to increased contamination, inadequate preoperative optimization, and compromised nutritional status. Diabetes and obesity were significant risk factors for SSIs. Proper wound care, adherence to surgical protocols, and targeted antibiotic therapy based on culture sensitivity are essential for minimizing SSI-related complications.