Official websites use. Share sensitive information only on official, secure websites. Surgical site infections SSIs are reported in lower frequencies in the developed countries than in the developing world. A prospective evaluation of risk factors in patients undergoing abdominal surgery procedures in Zimbabwe was therefore undertaken. High wound class, high ASA score, blood transfusion, HIV infection and delayed use of prophylactic antibiotics were risk factors for SSIs, resulting in surgical interventions, prolonged hospital stay and mortality.
Bacterial burden is a major risk factor for postoperative wound sepsis 2 , 3. Potential sources of bacteria are the patient, the surgical team and the operating environment. Preventive measures should target these potential sources. The most common complication of abdominal surgery is SSI. The associated morbidity contributes to increased length of hospital stay and costs 4 , 5 , 6 , 7 , 8.
Risk factors may be related to age, immune suppression, wound class, duration of operation, ASA American Society of Anesthesiologists score, prophylactic antibiotics, blood transfusion, use of steroids and smoking 9. Blood transfusion causes immune tolerance and predisposes to SSI 5 , 11 , Wound class is an independent predictor of SSI 2. A high ASA score has been correlated with high wound infection rates 13 , 14 , Reduction in wound infection rates has been achieved by proper timing of prophylactic antibiotics 16 , 17 , 18 , 19 , 20 , adequate blood glucose control 21 , 22 , avoidance of hypothermia 23 , 24 and adequate tissue oxygenation by control of perfusion and administration of supplemental oxygen 25 , 26 , 27 , 28 , Frequencies of SSI in hospitals at developed countries are lower than in teaching hospitals in Africa and South America 30 , 31 , 32 , 33 , 34 , Factors contributing to the high frequencies of SSI in developing countries must be known in this environment before corrective measures can be undertaken.
Therefore, the aim of this study was to prospectively determine frequency and risk factors for abdominal SSIs in Harare Teaching Hospitals and evaluate their importance. A prospective observational study was carried out on patients admitted for elective or emergency abdominal surgery in general surgical and gynaecological wards at Harare and Parirenyatwa University Teaching hospitals during the period from May to June Voluntary counselling and testing for HIV infection were done in consenting patients.
Prophylactic antibiotics were given according to protocols used in the different wards. Various combinations of antibiotics were used; however, only two different combinations of antibiotics were possible to compare owing to few patients.
