Early post-operative wound infections at the Kenyatta National Hospital: a prospective study

Abstract

A prospective study of 292 patients undergoing surgical operations in the General Surgical firms at the Kenyatta National Hospital was carried out to assess early clinical post-operative wound infection. This outcome was studied in relation to 3 broad variables: Endogenous contamination, exogenous contamination and patient factors. Methodology: Patients were recruited over a two and a half months period, between 1ih February 2003 and 23rd April 2003, according to set criteria. Each patient was followed up until discharge, and where necessary in the out-patient clinics. Data was entered into a questionnaire and analysed for statistical differences in the variables mentioned. Results: Fifty-one out of292 patients got post-operative wound infection. Endogenous contamination of the wound at the time of surgery was found to be of great significance in predicting wound infection (p<0.001). The clean wound infection rate of Kr-H was found to be 3.1 per cent, whereas the overall wound infection rate was 17.4 per cent. There was no significant difference in the clean wound or overall wound infection rates between the individual surgical firms (p value 0.6) Variables in the exogenous contamination and patern host categories that were found to be of significance included prolonged pre-op stay, pre-op shaving, presence of cornorbidities, low levels of haemoglobin and blood transfusion, among others. Patients who got infection had a significant increase in their post-op stay and hospitalization costs (p<0.001). Conclusion: Despite marked improvement in rates over the years, post-op wound infection at KNH remains an important cause of morbidity and financial burden. Recommendations have been made on further attempts at reduction of the rates, based on findings of this study