FACTORS ASSOCIATED TO SURGICAL SITE PERIOPERATIVE INFECTION IN APPENDECTOMIES AT A HOSPITAL OF PARÁ SOUTHWEST

Abstract

Introduction: Appendectomy is the definitive treatment for acute appendicitis (AA). Hospital XXX is responsible for 97% of appendectomies in its municipality. However, surgical site infection (SSI) is known to hinder favourable patient outcomes, thereby necessitating proper investigation into the factors conditioning its institutional epidemiology. Methods: This is a primary, cross-sectional, descriptive-analytical study involving patients who underwent appendectomy at Hospital XXX, with and without perioperative SSI. Included were male patients admitted between January and December 2024, aged 18 to 60 years and without comorbidities. Results: Out of 888 medical records reviewed, 67 were eligible for the study, of which five (7.4%) presented signs of SSI within 30 days, such as purulent drainage (100%), localized pain (50%) and/or incisional diagnosis (50%). Significant risk factors for infectious events included complicated AA (22.2% vs. 5.1% SSI in uncomplicated cases), inadequate aseptic measures (13.04% vs. 4.54% with proper asepsis/antisepsis), and preoperative antibiotic prophylaxis using cephalosporins as monotherapy (80% of SSIs). Discussion: The annual absolute incidence of 7.4% for perioperative SSI in appendectomies at Hospital XXX is consistent with national and global estimates — around 8%. As highlighted in the analysis, preoperative prophylaxis with cephalosporins alone — which offer limited coverage against aerobic and anaerobic microorganisms — and irregular alcohol-based asepsis/antisepsis are classically associated with SSI in appendectomies and other gastrointestinal surgeries. Conclusion: The SSI data from Hospital XXX reveal deficiencies that adversely affect the recovery of appendectomized patients, such as irregular surgical asepsis; antimicrobial therapy with incomplete spectrum; and inadequate management of complicated appendicitis. It is imperative to conduct a single-centre cohort study to address this study's methodological limitations and to support the rigorous institutional adoption of aseptic and antimicrobial protocols.