Background: Surgical site infections are a major cause of postoperative morbidity and mortality, but data regarding their prevalence in Greece are scarce. In this study, we report the rates of surgical site infections after major abdominal surgery in a large sample of patients in Greece.
Methods: This was a prospective multicentre trial (NCT 05393752) including 11 tertiary hospitals from Greece and Cyprus. Patients undergoing major/major+ abdominal surgery during 2022-2023 were included. Surgical site infections were classified according to the definitions of the CDC, and for sepsis, the SEPSIS-3 criteria were used. Demographics, type/site/magnitude of the operation, American Society of Anesthesiologists class, and the presence/stage of malignancy, as well as comorbidities, were recorded.
Results: There were 1649 patients (41,8% females) with a mean age of 66.3 years (SD: 13.8). The most common site of operation was the lower GI tract (58,9%), followed by the upper GI tract (20.2%) and the hepatobiliary system (13.6%). A total of 30.6% of the operations were performed on an emergency basis, and 3% of the patients had sepsis/shock. The rates of smoking, COPD, diabetes, corticosteroid use, and chronic renal failure were 23.5%, 9.7%, 22%, 6.5%, and 0,8%, respectively. Cancer diagnosis was present in 68.2% of patients and distant metastases in 9.7%. Postoperatively, 7.5% of patients developed sepsis and 3.3% developed septic shock. A total of 322 SSIs were recorded (19.8%), of which 13.3% were superficial, 2.7% deep, and 3.5% were in the organ space. SSIs were significantly more common in emergency operations, in hepatobiliary sites, and in patients with cancer (p<0.01).
Conclusion: SSIs are common after major abdominal surgery, even though most of them are superficial. At relatively high risk are hepatobiliary, oncological, and urgent operations.
