Effect of Personal Protective Equipment (PPE) on Surgical Site Infection in Emergency Laparotomy: An Observational Study From a Tertiary Care Centre

Abstract

Background In the era of the coronavirus disease 2019 (COVID-19) pandemic, the use of full personal protective equipment (PPE) is advocated for patients undergoing emergency surgery in whom the infection status is unknown. This study aims to determine whether PPE has any influence on the rate of surgical site infection (SSI) in patients undergoing emergency exploratory laparotomy. Methodology Medical records of operated emergency cases in the general surgery department from 1st April 2020 to 24th February 2021 were studied. The surgeries done were divided into two groups: those done with full PPE (group A) and those done without full PPE (group B). The various parameters studied were the patient demography, presence of comorbidities, diagnosis, surgery done, class of surgery performed, the use of PPE, the post-operative presence, and type of SSI. Statistical analysis was done using SPSS software version 27.0 (IBM Corp., Armonk, NY). Chi-squared test was used to find the association of SSI with the use of PPE. Fisher's exact test was used to explore the association between SSI with various comorbidities, surgery performed, and the class of surgery performed. Results A total of 126 patients underwent emergency exploratory laparotomy during the study period. A total of 61 patients were in group A and 65 patients in group B. A significant association was noted between the use of full PPE and the development of SSI (p = 0.032). Diabetes mellitus, history of alcohol intake, and the class of surgery performed were found to be significantly associated with the development of SSI. Conclusion A significant association in the occurrence of SSI with the use of full PPE was observed.

Keywords: emergency laparotomy; emergency surgery; personal protective equipment; postoperative wound infection; ppe; surgical site infection; surgical wound infection.