Prevalence, Incidence and Risk Factors for Port Site Infection Following Laparoscopic Surgery: A Multicenter Study in Bangladesh
Keywords:
Port site infection, Laparoscopy, Risk factors, Bangladesh, Sterilization, Postoperative complicationAbstract
Introduction: Port site infection (PSI) is a significant postoperative complication of laparoscopic surgery, potentially leading to prolonged hospitalization, morbidity, and increased healthcare costs. Limited data exist regarding PSI incidence and risk factors in Bangladesh. This study aimed to determine the prevalence and incidence of PSI among patients undergoing laparoscopic surgery and to identify patient- and procedure-related risk factors, including instrument sterilization practices.
Methods: A prospective observational study was conducted on 93 patients undergoing elective laparoscopic procedures at Bangladesh Medical University and selected private hospitals (Popular General Hospital and East West Medical College Hospital) from January 2021 to December 2023. Postoperative PSI was assessed based on CDC criteria. Data collected included demographics, comorbidities, operative details, and instrument sterilization practices. Logistic regression was used to identify independent risk factors.
Results: The overall incidence of PSI was 14% (13/93). Significant risk factors included diabetes mellitus (OR 3.2, 95% CI 1.1–9.4, p=0.03), obesity (BMI >30) (OR 2.5, 95% CI 0.9–6.8, p=0.05), prolonged operative time (>90 minutes) (OR 2.8, 95% CI 1.0–7.6, p=0.04), and faulty sterilization of laparoscopic instruments (improper preparation of 3% glutaraldehyde solution, expired solution, inadequate contact time, faulty drying, tap water contamination, or instruments previously used for TVS TV patients not properly sterilized) (OR 4.5, 95% CI 1.4–14.0, p=0.01). All superficial infections resolved with conservative management, while deep infections required drainage. No mortality was reported.
Conclusion: PSI remains a significant complication in Bangladesh. Both patient factors (diabetes, obesity, prolonged operative time) and procedural factors, particularly improper instrument sterilization, are key contributors. Strict asepsis and quality control in sterilization can reduce PSI and improve outcomes.
Journal of Surgical Sciences 2024;28(1): 3-8
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