2025, Vol. 7, Issue 4, Part A

Background: Surgical site infections (SSIs) remain a significant complication following laparoscopic appendectomy despite advances in surgical techniques and antimicrobial prophylaxis. This study aims to determine the incidence and risk factors for SSIs following laparoscopic appendectomy in a tertiary care hospital in Iraq.

Objectives: To establish the incidence of SSIs after laparoscopic appendectomy, identify associated risk factors, and evaluate the microbial profile of isolated organisms from infected sites.

Methods: A prospective cohort study was conducted on 280 patients undergoing laparoscopic appendectomy at Al-Diwaniyiah Teaching Hospital between January 2022 and December 2023. Patients were followed up for 30 days post-operatively. SSI was defined according to CDC criteria. Univariate and multivariate logistic regression analyses were used to identify independent risk factors.

Results: The overall incidence of SSI was 8.2% (23/280 cases). Superficial incisional SSI accounted for 60.9% (14/23), while deep incisional and organ/space SSIs comprised 26.1% and 13.0% respectively. Independent risk factors included female gender (OR: 2.45, 95% CI: 1.12-5.36), preoperative anemia (OR: 3.18, 95% CI: 1.44-7.02), complicated appendicitis (OR: 4.67, 95% CI: 1.89-11.53), and prolonged operative time (>90 minutes) (OR: 2.89, 95% CI: 1.23-6.78). Escherichia coli (52.2%) and Staphylococcus aureus (34.8%) were the most commonly isolated organisms. The mean hospital stay was significantly longer in infected patients (6.2±2.1 days vs. 2.8±1.3 days, p<0.001).

Conclusion: The incidence of SSI after laparoscopic appendectomy in this population is 8.2%, which is comparable to international standards. Female gender, preoperative anemia, complicated appendicitis, and prolonged operative time are significant risk factors that should guide perioperative management strategies.