Clinical characteristics and risk factors for surgical site infections of type Ⅰ incision in patients undergoing grade Ⅲ and Ⅳ surgeries

OBJECTIVE To explore the clinical characteristics and risk factors for surgical site infections (SSI) in the patients undergoing type Ⅰ incision surgeries of grade Ⅲ and Ⅳ so as to provide theoretical bases for effective prevention and control of SSI.

METHODS The clinical data were prospectively collected from 280 patients with SSI who received major type Ⅰ incision surgeries of grade Ⅲ and Ⅳ in the key departments of the Second Affiliated Hospital of Jiaxing University from Jan. 2021 to Jun. 2024, and randomly from another 280 patients without infections. The enrolled patients were assigned as the infection group and the no infection group, respectively. The clinical characteristics of the SSI were analyzed. The baseline data, including sex, age, hypertension, diabetes mellitus, hyperlipidemia, heart disease, hepatorenal function, nutrition status, preoperative length of hospital stay, operation duration, implantation materials, emergency surgery, intraoperative warm maintenance, microscope, blood loss volume, blood transfusion and postoperative intensive care unit (ICU) stay as well as severe hypoproteinemia, were collected from the enrolled patients. Univariate analysis and logistic regression analysis were performed for the influencing factors for the SSI.

RESULTS A total of 16, 706 patients underwent neurosurgery, orthopedics and cardiothoracic surgery, 280 of whom had SSI, the incidence of SSI was 1.68%. Totally 264 strains of bacteria were isolated, 53.03% of which were gram-positive bacteria, 46.97% were gram-negative bacteria; Staphylococcus aureus was the most common species of pathogenic bacteria. The result of multivariate logistic analysis showed that the nutrition status, operation duration, microscope, postoperative ICU and severe hypoproteinemia were the risk factors for the SSI (P < 0.05).

CONCLUSIONS The SSI is common among the patients undergoing typeⅠ incision surgeries of grade Ⅲ and Ⅳ. It is necessary for the hospital to take targeted intervention measures in early stage based on the risk factors.