Predictive factors of surgical site infections in abdominal wall hernias

Siddharth Keswani, Murtaza Akhtar, Divish Saxena, Gayatri Deshpande


Background: Surgical site infections (SSI) are infections presents in any location along the surgical tract after a surgical procedure. Knowledge of predictive factors associated with SSI is important for planning remedial measures. Abdominal wall hernia repair is a common procedure in general surgery practice and knowing the predictors of SSI in these clean surgeries requiring placement of mesh is the aim of the present study.

Methods: In a hospital based longitudinal study the subjects were diagnosed cases of anterior abdominal wall hernias undergoing planned or emergency surgeries. Patients of either gender and age group of 18 to 80 years were included in the study. Patients undergoing laparoscopic hernia repair were excluded. The study factors were patient and the surgeon related factors like laboratory parameters, surgeon experience etc. The outcome was SSI assessed with up to 30 days post-operative follow up.

Results: Total 198 patients were enrolled with a mean age of 42.49±15.72 years and male preponderance. Overall SSI rate was 9.09% and in planned cases it was 7.07% and 50% in emergency cases. Pre-operative hospital stays of >5 days was the only patient factor associated with increased risk of SSI (p=0.0004) and operating surgeon’s experience was associated with increased risk if SSI i.e. cases operated by junior surgeons had a higher risk of SSI (p=0.013).

Conclusions: The only modifiable factor associated with SSI was pre-operative hospital stay of >5 days while high incidence of SSI with junior surgeons cannot be modified in a teaching institute.


Abdominal wall hernia, Pre-operative hospital stays, SSI, Surgeon seniority

Full Text:



Ahmed MI. Prevalence of Nosocomial wound Infection among Postoperative patients and Antibiotics patterns at Teaching Hospital in Sudan. North Am J Med Sci. 2012;4(1):29-34.

Anusha S, Vijaya LD, Pallavi K, Manna PK, Mohanta GP, Manavalan R. An Epidemiological Study of Surgical Wound Infections in a Surgical unit of Tertiary Care Teaching Hospital. Indian J Pharm Pract. 2010;3(4):8-13.

Anvikar AR, Deshmukh AB. A one-year prospective study of 3280 surgical wounds. IJMM. 1999;17(3):129-32.

Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005;23:249-52.

Mahesh C B, Shivakumar S, Suresh BS, Chidanand SP, Vishwanath Y. A prospective study of surgical site infections in a teaching hospital. J Clini Diag Res. 2010;4:3114-9.

Ganguly PS, Khan Y. Malik A. Nosocomial infection and hospital procedures. Indian J. Common Med. 2000;990-1014.

Koch R. Investigations into the etiology of traumatic infective diseases. New Sydenham Society; 1880.

E-medicine. Inguinal Region Anatomy: overview, gross anatomy, pathophysiological variants. Available at: Accessed 9 November 2015.

Masood A, Nadeem SL. Post-operative wound infection: A surgeon‘s dilemma. Pakistan J Surg. 2007;3(1):42-5.

Sahu S, Shergill J, Sachan P, Gupta P. Superficial incisional surgical site infection in elective abdominal surgeries-A prospective study. Internet J Surg. 2011;26(1):514-24.

Saxena A. Surgical site Infection among postoperative patients of tertiary care centre in Central India-A prospective study. Asian J Biomed Pharma Sci. 2013;3(17):41.

Drapeau CM, Pan A. Surgical site infections in HIV-infected patients: results from an Italian prospective multicentre observational study. Infect. 2009;37(5):455-60.