Surgical Site Infection in Orthopedic and Trauma Surgery at Kinshasa University Clinics

Author(s): Julien Edunga BOSSA, Remy Bayaa MADEE, Aliocha Natuhoyila NKODILA, Marie-Ange kalambay MBUYI, Luc Bakumobatane MOKASSA

Background: The objective of our study is to identify risk factors, determinants of surgical site infection in our study population and predict the occurrence of surgical site infection according to National nosocomial infection score.

Method: This is a retrospective observational cohort study, conducted in orthopedic and trauma surgery at the Kinshasa University Clinics in Congo/kinshasa, from 2010 to 2021.

Results: A total of 247 patients underwent surgery, 61.1% men and 38.9% women, with a sex ratio of 2H/1F. The mean age was 40.5±18.1 years, with the 20-29 (20.2%) and 30-39 (23.9%) age groups the most represented. The incidence of SSI was 15%, with organ infections predominating (7.7%). A minority, 5.7%, were at high risk of surgical site infection. The national nosocomial infection score was retained as a predictive factor for surgical site infection in at-risk individuals (p=0.033). Male gender [(aOR: 1.93; 95% CI: 1.09-3.43); p = 0.025], emergency surgery [(aOR: 4.58; 95% CI: 1.36-5.45); p = 0.014] and preoperative duration greater than 24 h [aOR: 1.98; 95% CI: 1.02-3.82); p = 0.043] were factors independently and significantly associated with the risk of SSI.

Conclusion: The frequency of SSI is equivalent to that obtained in regions sharing a similar socio-economic context to our own and remains high compared with results from developed countries. Male gender, emergency surgery and preoperative duration of more than 24 hours are factors favoring SSI in our institution, with a National nosocomial infection score retained as a predictive factor.