Prevalence and Risk Factors of Surgical Site Infections Associated with War-Related Penetrating Abdominal Trauma in Yemen

Abstract

Purpose This study aimed to investigate the prevalence, risk factors, and outcomes of surgical site infections (SSIs) in patients with war-related penetrating abdominal trauma in Yemen. Patients and methods: A prospective cohort study was conducted involving 120 male patients (mean age, 25.52 years) who presented with penetrating abdominal trauma and underwent laparotomy. Data on demographic characteristics, injury mechanisms, clinical presentations, intraoperative findings, and postoperative outcomes were collected and analyzed. Results The prevalence of SSIs was 56.67%. Organ/space SSIs were the most common type (21.67%), followed by superficial incisional SSI (18.33%) and deep incisional SSI (16.67%). Significant risk factors for SSIs included hollow viscus injuries (p = 0.003), small bowel injuries (p = 0.038), higher median PRBC units received within 24 hours (p = 0.000), lower serum albumin levels (p = 0.003), and a higher number of exploratory laparotomies (p = 0.000). The median time from injury to surgery was longer in patients with SSIs (p = 0.006). However, logistic regression showed patients who received more PRBC units were less likely to develop SSIs (OR : 0.490, CI: 0.297–0.808 ,p = 0.005). Postoperative complications included anastomotic leaks (13.33%), septicemia (30%), and reoperation (20%). The mean length of ICU admission was 2.13 days, and the mean length of hospital stay was 8.56 days. Conclusion This study revealed a high prevalence of SSIs among patients with war-related penetrating abdominal trauma in Yemen. Key risk factors include hollow viscus and small bowel injuries and the need for extensive blood transfusions. The findings emphasize the importance of timely resuscitation and strict infection control measures to reduce SSIs and improve patient outcomes in conflict-affected regions. Enhanced medical infrastructure and effective intervention strategies can mitigate the burden of SSIs. Future research should explore the impact of blood transfusion practices and advanced infection control protocols in such settings.