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Why reducing post-surgical infections ‘needs to be a priority’ in low-income countries

A surgical site is the incision or cut in the skin made by a surgeon to carry out a surgical procedure. Can these be reduced?

At the military hospital in Zaporizhzhia, surgeons have been working around the clock to tend those wounded in the war - Copyright POOL/AFP Anthony Kwan
At the military hospital in Zaporizhzhia, surgeons have been working around the clock to tend those wounded in the war - Copyright POOL/AFP Anthony Kwan

Investing in safe surgery could cut costs and save lives, finds a new study into medical practices and healthcare controls. This relates to an assessment of surgical site infections, which can occur as the result of a surgical procedure when introduced by operating theatre personnel or from the operating area environment. A surgical site infection occurs as microorganisms get into the part of the body that has been operated on and proceed to multiply in the tissues.

Patients who go on to develop a surgical site infection experience pain, disability, poor healing with risk of wound breakdown, and prolonged recovery times as well as psychological challenges.

A new report finds that investing in developing systems of safe surgery will additionally help to reduce the financial burden upon health services. This could prove to be especially beneficial for those residing in low- and middle-income countries.

Analysing inpatient resource use in India, Ghana, Nigeria and Mexico, researchers have discovered that additional investigations and hospital length of stay for a patient with a surgical site infection compared to patient without an infection were generally higher in clean-contaminated surgical cases compared to contaminated-dirty surgical cases.

It was discovered that surgical site infections occurred in 7 percent of clean-contaminated cases, where wounds have no signs of infection at the time of surgery. In contrast, 27 percent of contaminated-dirty cases – situations where the wound encounters bodily fluids – exhibited a surgical site infection.

In terms of healthcare economics, a surgical site infection was associated with an increase in postoperative healthcare costs by 75.3 percent (€412) after clean-contaminated surgery and 66.6 percent (€331) after contaminated-dirty surgery. Overall, inpatient costs accounted for 96.4 percent of total healthcare costs after clean-contaminated surgery and 92.5 percent after contaminated-dirty surgery.

Data for the research was drawn from Benin, Ghana, India, Mexico, Nigeria, Rwanda and South Africa.

The data analysis showed that surgical site infections were a statistically significant variable in determining postoperative healthcare costs.

Lead researcher Mark Monahan (University of Birmingham) states: “Surgical site infection is the world’s most common postoperative complication. This is the first multi-continental surgical cost study of its kind and reveals substantial additional postoperative costs associated with SSI across a range of settings.”

Monahan  contends that investing in health technologies to reduce surgical site infections could reduce this financial burden to patients and low-resource health systems.

The research has been published in the Journal of Hospital Infection. The research is titled “The costs of surgical site infection after abdominal surgery in middle-income countries: Key resource use In Wound Infection (KIWI) study.”

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Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, business, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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