Surgical Site Infections is the Concerning Issue in Pakistan: A Review Article

Musawir  Hussain; Muhammad  Hamayun; Umair  Shafique; Muhammad  Zaman; Muhammad Abdul  Rahman; Zain Ul  Abbas; Muhammad  Aqib; Khadija  Muqadas; Muhammad Subhan  Nazar

doi:10.54112/bcsrj.v6i1.1519

Authors

Musawir Hussain Pakistan Institute of Medical and Management Sciences, Khyber Medical University, Khyber Pakhtunkhwa, Pakistan
Muhammad Hamayun Department of Public Health, the University of Haripur, Khyber Pakhtunkhwa, Pakistan
Umair Shafique Department of Emerging Allied Health Technologies, Superior University Lahore, Punjab, Pakistan.
Muhammad Zaman Department of Microbiology, The Islamia University of Bahawalpur, Punjab, Pakistan.
Muhammad Abdul Rahman Department of Public Health, Times Institute Multan, Punjab, Pakistan.
Zain Ul Abbas Department of Microbiology, Government College University, Faisalabad, Punjab, Pakistan
Muhammad Aqib Department of Public Health, The University of Haripur, Khyber Pakhtunkhwa, Pakistan
Khadija Muqadas Department of Public Health, The University of Haripur, Khyber Pakhtunkhwa, Pakistan
Muhammad Subhan Nazar Department of Public Health, The University of Haripur, Khyber Pakhtunkhwa, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i1.1519

Keywords:

Incidence, Prevalence, SSI, AMR, CHG, Medical device, AORN, Pakistan.

Abstract

Surgical Site Infections (SSIs) are a significant healthcare-associated infection, particularly in low- and middle-income countries (LMICs) like Pakistan. This review article evaluates the incidence, prevalence, risk factors and role of medical devices in surgical site infections. A literature review was conducted to assess the incidence, risk factors, and preventive strategies for SSIs. Studies comparing povidone-iodine (PI) and chlorhexidine gluconate (CHG) for skin antisepsis, normothermia and data on the effectiveness of sterile surgical attire and negative pressure wound therapy were analysed. SSI rates in LMICs range from 8-30%, compared to 1-4% in high-income countries. Risk factors include patient-related variables (e.g., malnutrition, immunosuppression), surgical factors (e.g., contamination, poor sterilisation), and physiological factors (e.g., postoperative hypoxia). CHG combined with alcohol-based preparations is more effective than PI. Maintaining normothermia, proper sterilisation, and using disposable medical equipment can reduce SSI rates. Preventive strategies include training on CHG use, mandatory disposable sterile drapes and gowns, adherence to AST and AORN guidelines for surgical attire, and continuous education for perioperative staff. Implementing comprehensive CHG combined with alcohol-based preparations, normothermia, negative pressure wound therapy, ongoing education programs, and robust preventive strategies are essential to reduce SSIs, especially in LMICs, improving patient outcomes and healthcare sustainability.

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