Publication:

Surgical site infections in emergency vs elective surgery: a cross-sectional comparison

Background Surgical site infections (SSI) are among the most common postoperative complications, leading to increased morbidity, prolonged hospitalization, and higher healthcare costs. Emergency surgical procedures are particularly associated with higher infection rates because of limited preoperative preparation and a greater likelihood of contaminated wounds. This study compared the incidence of SSI between emergency and elective surgeries and evaluated associated risk factors and postoperative outcomes.

Methods This cross-sectional comparative study was conducted in the Department of Surgery, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh, from January 2025 to December 2025. A total of 104 patients were enrolled using purposive sampling, including 52 undergoing emergency surgery and 52 undergoing elective surgery. Data were analyzed using SPSS version 26.0.

Results The overall SSI rate was 19.2%. SSI occurred significantly more often in emergency surgeries (28.8%) than in elective surgeries (9.6%). Emergency procedures were more frequently associated with prolonged operative duration and contaminated or dirty wounds. Significant risk factors for SSI included diabetes mellitus, smoking, prolonged surgery (>2 hours), and wound contamination. Patients who developed SSI experienced significantly longer hospital stays, higher reoperation rates, and increased 30-day readmission rates compared with those without infection.

Conclusion Surgical site infections are significantly more common following emergency surgery than elective procedures. The higher SSI rate in emergency operations is largely attributable to greater wound contamination, longer operative times, and limited opportunities for preoperative patient optimisation.