Comparative Prospective Study of Surgical Site Infection in Emergency and Elective Open Abdominal Surgery

BackgroundSurgical site infection (SSI) is a major postoperative complication following open abdominal surgery.This study compared 30-day SSI occurrence after emergency and elective surgery and evaluated microbiological findings, postoperative outcomes, and associated factors. MethodsThis prospective comparative observational study included 100 adults undergoing open abdominal surgery at a tertiary care hospital over 18 months.Patients were consecutively recruited into elective (n = 50) and emergency (n = 50) groups and followed for 30 days.Categorical variables were compared using chi-square or Fisher's exact tests.Relative risks (RRs), crude odds ratios, and adjusted odds ratios (AORs) were calculated. ResultsSSI occurred in 30 patients (30.0%), including 19 (38.0%) in the emergency group and 11 (22.0%) in the elective group (RR = 1.73, 95% CI: 0.94-3.19;p = 0.081).Mortality was higher after emergency surgery (32.0% vs. 10.0%;RR = 3.20, 95% CI: 1.29-7.94;p = 0.007).Escherichia coli was the most frequently isolated organism (13/30, 43.3%), followed by Staphylococcus aureus (10/30, 33.3%), Klebsiella spp.(4/30, 13.3%), and Pseudomonas aeruginosa (2/30, 6.7%); one culture showed no growth.Antimicrobial susceptibility classification was sensitive in 24 cases (80.0%) and resistant in six (20.0%).Neither culture distribution (p = 0.073), susceptibility classification (p = 0.641), nor clinical response (p = 0.156) differed significantly between groups.Multivariable analysis found no statistically significant association between SSI and emergency surgery (AOR = 1.95, 95% CI: 0.78-4.92),male sex (1.69, 0.60-4.74),diabetes (0.73, 0.13-4.19),addiction history (1.21, 0.33-4.46),or age (0.99 per year, 0.96-1.01). ConclusionSSI was more frequent after emergency surgery, but the difference was not statistically significant.Mortality was significantly higher in the emergency group.Larger prospective studies using standardized SSI definitions and antimicrobial susceptibility methods are needed.