Frequency of Surgical Site Infection Following Primary Closure in Patients with Enteric Perforation: A Case Series

Abstract

OBJECTIVES

This study aimed to determine the frequency of surgical site infection (SSI) following primary closure in patients presenting with enteric perforation and to evaluate the association of age and gender with SSI.

METHODOLOGY
 This descriptive case series was conducted in the Department of General Surgery, Lady Reading Hospital, Peshawar, from June 2024 to March 2025. A total of 273 patients aged 18-60 years undergoing emergency laparotomy for enteric perforation were included through consecutive sampling. Patients with diabetes mellitus, uremia, obesity, secondary gut leaks, or steroid intake were excluded to control confounders. Surgical site infections were assessed on the 7th postoperative day based on clinical features and confirmed by culture. Data were analyzed in SPSS 10.0. Mean ± SD was calculated for continuous variables, while frequencies and percentages were used for categorical variables. A chi-square test was applied, with p < 0.05 considered statistically significant.

RESULTS
The mean age of the patients was 36.61 ± 10.16 years, with the majority (42.12%) falling within the 31–40 years age group. Overall, 107 patients (39.19%) developed SSI. No mortality was reported. Stratified analysis showed no statistically significant association between SSI and gender (p = 0.681) or age group (p = 0.705).

CONCLUSION

A high frequency of SSI was observed following primary closure in enteric perforation. Neither age nor gender was significantly associated with SSI, indicating that other factors, such as contamination level, surgical technique, and perioperative management, may play a more critical role. Consideration of delayed primary closure and strict infection-control measures may help reduce SSI in these high-risk cases.