POSTOPERATIVE WOUND INFECTION RATES FOLLOWING ELECTIVE VS. EMERGENCY LAPAROTOMIES: A COMPARATIVE STUDY

Abstract

Background: Wound infection after surgery is a leading source of morbidity after abdominal surgery, especially laparotomies. The increased infection extends the hospital stays, discomfort of the patient, and healthcare expenses. Emergency surgeries are usually conducted under suboptimal conditions, which may increase the risk of acquiring surgical site infections (SSIs). The purpose of the study was to compare the postoperative wound infection in elective and emergency laparotomies and determine the important factors underlying these infections.

Methods: A prospective comparative analysis was conducted on 80 laparotomy patients in one of the tertiary healthcare centers for 3 months. The participants were categorized according to the surgical urgency into elective (n = 40) and emergency groups (n = 40). Patient demographics, comorbidities, wound type, operative time, American Society of Anesthesiologists (ASA) Physical Status Classification System scores, and antibiotic prophylaxis time were recorded. Surgical site infections were classified using the Centers for Disease Control and Prevention (CDC) guidelines and evaluated within 30 days after surgery. Statistical analysis was performed using the chi-square test and independent t-test with a level of significance at p < 0.05.

Results: Emergency laparotomies had a higher wound infection rate (30%) than elective ones 5 (12.5%, p = 0.031). In the emergency group, there were more incidences of anemia (16 (40%) vs. 6 (15%), p = 0.008), wound contamination (14 (35%) vs. 4 (10%), p = 0.007), long operation time (>2 hours), higher ASA grades, and delayed prophylactic antibiotic use (8 (20%) vs. 2 (5%), p = 0.045). These were significantly linked to a high risk of SSI.

Conclusion: There is a greater risk of postoperative wound infection after emergency laparotomies, and much of the risk is perioperative-related and modifiable. Intensive preoperative preparation, early antibiotic prophylaxis, and intensive infection control can contribute to mitigating the problem of SSIs in emergency abdominal surgery. It is necessary to define and tackle these risk factors to enhance surgical outcomes and patient recovery.