Assessment of Risk Factors for Surgical Site Infection in Diabetic Patients Undergoing Elective Surgery.

BACKGROUND

Surgical site infections (SSIs) remain a major postoperative complication, particularly among diabetic patients who are inherently at higher risk due to impaired immunity and delayed wound healing.

OBJECTIVE

To assess the risk factors associated with SSIs in diabetic patients undergoing elective surgical procedures.

METHODS

This retrospective study was conducted at Children Hospital Lahore, from April 2024 to April 2025. A total of 150 diabetic patients scheduled for elective surgery were enrolled using non-probability consecutive sampling. Preoperative, intraoperative, and postoperative variables were recorded, including glycemic indicators, comorbidities, operative duration, wound classification, antibiotic timing, and postoperative wound status.

RESULTS

The mean age of participants was 57.8 ± 11.4 years, and 58.7% were male. The overall SSI rate was 25.3% (n = 38). Higher HbA1c levels were significantly associated with SSI (8.4 ± 1.3 vs. 7.1 ± 1.0, p < 0.001). Operative duration of two or more hours (p = 0.02), contaminated wound classification (p = 0.01), smoking (p = 0.03), and incorrect antibiotic prophylaxis timing (p = 0.04) were also significantly correlated with infection. Logistic regression identified poor glycemic control (adjusted odds ratio (AOR) 3.1, 95% CI: 1.6-5.9), prolonged surgery (AOR 2.4, 95% CI: 1.1-4.8), contaminated wound class (AOR 2.9, 95% CI: 1.3-6.5), and smoking (AOR 1.9, 95% CI: 1.01-3.8) as independent predictors of SSI. Patients who developed SSI had significantly longer hospital stays (9.8 ± 3.1 vs. 5.3 ± 1.9 days, p < 0.001).

CONCLUSION

It is concluded that SSIs in diabetic patients are strongly linked to modifiable perioperative factors. Poor glycemic control, prolonged operative duration, contaminated wounds, and smoking significantly increase infection risk.