Incidence and Risk Factors for Surgical Site Infections in Diabetic Patients Undergoing Clean Surgeries: A Prospective Observational Study

Dr. Vemula Bhargava Ram, Dr. Ganesh Babu KM

Abstract: Background: Diabetes mellitus is a recognized risk factor for postoperative surgical site infections (SSIs), even in clean surgical procedures. However, the specific incidence and contributing risk factors in patients with diabetes remain underreported in semi-urban healthcare settings. Objectives: To determine the incidence of SSI among patients with diabetes mellitus (DM) undergoing clean elective surgeries and identify patient and procedure-related risk factors contributing to SSI development. Methods: A prospective observational study will be undertaken at the "Akash Institute of Medical Sciences and Research Centre, Department of General Surgery", over a duration of 12 months. All adult patients with diabetes who are scheduled for non-emergency elective surgery will be included upon obtaining informed consent. Data about demographic parameters, diabetes management (HbA1c), surgical variables, and postoperative outcomes will be gathered. SSI will be diagnosed according to the CDC recommendations. Statistical analysis was employed to identify significant risk factors for the development of SSI. Results: This prospective study comprised 140 diabetic patients who underwent clean elective surgery. The mean age of the participants was 54.6?10.2 years, with a male predominance of 61.4%. A predominant proportion of patients (92.8%) received a diagnosis of type 2 diabetes mellitus, with an average duration of the disease of 8.1 ? 4.5 years. Suboptimal glycaemic management (HbA1c >8%) was noted in 55.7% of the study cohort. Additional comorbidities comprised hypertension (52.8%) and ischaemic heart disease (15.0%). Laparoscopic surgeries accounted for 64.3% of the procedures, whereas 35.7% underwent open surgeries. The mean duration of surgery was 72 ? 20 min, and surgical drains were placed in 24.3% of cases. All patients received prophylactic antibiotic therapy. The total incidence of SSI was 12.9% (n=18). Of the subjects, 8.6% experienced superficial incisional surgical site infections (SSI), 3.6% had deep incisional SSI, and 0.7% developed organ/space SSI. Microbiological cultures yielded positive results in 94.4% of instances, with Staphylococcus aureus (MSSA) identified as the predominant pathogen (44.4%), followed by "Escherichia coli (ESBL)" and "Methicillin-resistant Staphylococcus aureus" (MRSA). Conclusion: This study highlights that diabetes mellitus, particularly with poor glycemic control, significantly increases the risk of SSI, even in clean surgeries. Modifiable factors, such as preoperative glycemic optimization, obesity control, minimization of surgical time, and preference for laparoscopic approaches, can reduce the incidence of SSI in patients with diabetes.

Keywords: Surgical Site Infection, Diabetes Mellitus, Clean Surgery, Risk Factors, Prospective Study

How to Cite?: Dr. Vemula Bhargava Ram, Dr. Ganesh Babu KM, "Incidence and Risk Factors for Surgical Site Infections in Diabetic Patients Undergoing Clean Surgeries: A Prospective Observational Study", Volume 14 Issue 6, June 2025, International Journal of Science and Research (IJSR), Pages: 1524-1527, https://www.ijsr.net/getabstract.php?paperid=SR25621230130, DOI: https://dx.doi.org/10.21275/SR25621230130