Assessment of Risk Factors for Surgical Site Infection in Diabetic Patients Undergoing Elective Surgery

Background: Surgical site infections (SSIs) remain a major postoperative complication, particularly among diabetic patients who are inherently at higher risk due to impaired immunity and delayed wound healing. Objective: To assess the risk factors associated with SSIs in diabetic patients undergoing elective surgical procedures. Methods: This retrospective study was conducted at Children Hospital Lahore, from April 2024 to April 2025. A total of 150 diabetic patients scheduled for elective surgery were enrolled using non-probability consecutive sampling. Preoperative, intraoperative, and postoperative variables were recorded, including glycemic indicators, comorbidities, operative duration, wound classification, antibiotic timing, and postoperative wound status. Results: The mean age of participants was 57.8 ± 11.4 years, and 58.7% were male. The overall SSI rate was 25.3% (n = 38). Higher HbA1c levels were significantly associated with SSI (8.4 ± 1.3 vs. 7.1 ± 1.0, p < 0.001). Operative duration of two or more hours (p = 0.02), contaminated wound classification (p = 0.01), smoking (p = 0.03), and incorrect antibiotic prophylaxis timing (p = 0.04) were also significantly correlated with infection. Logistic regression identified poor glycemic control (adjusted odds ratio (AOR) 3.1, 95% CI: 1.6-5.9), prolonged surgery (AOR 2.4, 95% CI: 1.1-4.8), contaminated wound class (AOR 2.9, 95% CI: 1.3-6.5), and smoking (AOR 1.9, 95% CI: 1.01-3.8) as independent predictors of SSI. Patients who developed SSI had significantly longer hospital stays (9.8 ± 3.1 vs. 5.3 ± 1.9 days, p < 0.001). Conclusion: It is concluded that SSIs in diabetic patients are strongly linked to modifiable perioperative factors. Poor glycemic control, prolonged operative duration, contaminated wounds, and smoking significantly increase infection risk.