Patient-Related Predictors of Surgical Site Infections in Emergency Laparotomy: Role of Subcutaneous Fat Thickness, Stoma Creation, And Comorbidities

Abstract

Background & Objective: Surgical site infection is among the leading causes of postoperative complications, especially in emergency abdominal surgery. In the current article, the influence of subcutaneous fat thickness, comorbidities, and stomas on surgical site infection following emergency midline laparotomy is discussed.

Method: A prospective observational study was conducted at XXXX from February 2020 to September 2022. One hundred sixty patients who underwent emergency midline laparotomy were enrolled, and patients were split into the TSF with a subcutaneous drain or no subcutaneous drain group. Demographic information, comorbidities, BMI, TSF, and perioperative details were collected. SSI and hospital length of stay were documented. SPSS v21.0 was used for statistical analysis.

Result: SSIs happened in 31.25% of patients. Patients diagnosed with diabetes mellitus and having enrolled in TSF (>2.5 cm) were significantly less likely to have an SSI (28% vs. 12.7%, and 82% vs. 42.7%, respectively; p <0.01). Underweight BMI (<18.5) and hypertension contributed to higher SSI rates, with 25% in stoma patients compared to 10% in the drain group. TSF ≥ 2.5 cm and BMI ≥ 25 kg/m² were more prevalent in the control group, highlighting the benefits of subcutaneous drain placement. Patients with SSI had a longer median stay (15.3 days) compared to those without (9.1 days).

Interpretation & Conclusion: Increasing TSF, diabetes mellitus, hypertension, and stoma formation are significant predictors of SSIs following emergent laparotomy. Enhanced preoperative risk stratification and preventative measures, such as subcutaneous drain placement potential, may result in decreasing infection rates that also burden hospitals.