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Abstract
Background: Surgical site infection (SSI) is one of the most common complications following orthopedic surgery and is associated with prolonged hospital stay, increased healthcare costs, and poor patient outcomes. Understanding its prevalence and associated risk factors is essential for improving surgical care and infection prevention practices.
Objective: To determine the prevalence of postoperative surgical site infection among orthopedic surgery patients and identify patient-related, surgical, and hospital-related factors associated with SSI in tertiary care hospitals of Peshawar, Pakistan.
Methodology: A cross-sectional study was conducted among 357 orthopedic surgery patients from Khyber Teaching Hospital (KTH), Hayatabad Medical Complex (HMC), and Naseer Ullah Khan Babar Memorial Hospital (NKBMH). Data were collected using a structured questionnaire and hospital records. Statistical analysis was performed using SPSS version 27. Descriptive statistics summarized participant characteristics, while Chi-square tests, Mann–Whitney U tests, and multivariable logistic regression were used to identify factors associated with SSI. A p-value of <0.05 was considered statistically significant.
Results: The overall prevalence of surgical site infection was 14.0% (50/357). Superficial SSI was the most common type (8.1%), followed by deep SSI (4.5%) and organ/space SSI (1.4%). Wound classification, hypertension, ASA grade, and antibiotic prophylaxis showed significant associations with SSI in bivariate analysis. After adjustment, lack of prophylactic antibiotic administration remained the only independent predictor of SSI (Adjusted OR = 4.39, 95% CI: 2.10–9.20, p < 0.001). Patients with SSI also experienced significantly higher rates of readmission, re-operation, and prolonged postoperative hospital stay.
Conclusion: Surgical site infection remains an important postoperative complication among orthopedic surgery patients. Appropriate administration of prophylactic antibiotics plays a critical role in reducing the risk of SSI. Strengthening infection prevention practices and adherence to evidence-based surgical protocols can improve patient outcomes and reduce the burden of postoperative infections.