Risk factors and outcomes of surgical site infection after abdominoplasty: A retrospective study from Qatar.

BACKGROUND

Abdominoplasty, although classified as a clean elective procedure, carries a meaningful risk of surgical site infection (SSI), with reported SSI rates varying depending on patient factors and procedural complexity.

OBJECTIVE

To describe SSI incidence and associated risk factors after abdominoplasty at a Qatari tertiary facility, and to assess compliance with prophylaxis practices, antibiotic consumption, and costs.

METHODS

Retrospective cohort of all abdominoplasties at The Cuban Hospital, from January 1, 2022, to July 31, 2025 (N = 323). Data included demographics, comorbidities, perioperative glucose monitoring, procedure characteristics, and antibiotic use (prophylactic and therapeutic). The cohort comprised both simple abdominoplasties and combined procedures performed with additional interventions such as liposuction or hernia repair. SSI rates were analyzed using relative risk, 95% confidence intervals, and statistical tests with significance at P < 0.05.

RESULTS

A total of 323 patients underwent abdominoplasty with a mean age of 40.5 years (SD, 9.8; range, 19-63 years). The majority were female (276 patients, 85.4%), and 13.9% (45 patients) had a history of diabetes mellitus. Overall SSI incidence was 5.3% (17/323), highest in 2025 (8/112; 7.1%). Combined abdominoplasty had a higher SSI rate than simple procedures (10.4% [5/48] vs. 4.4% [12/275]; RR, 2.36 [95% CI, 0.88-6.35]). SSI was more frequent with diabetes (11.1% [5/45] vs. 4.3% [12/278]), overweight/obesity (7.3% [12/151]/4.3% [5/112] vs. 0% [0/42]), and higher postoperative glucose (mean: 7.97, standard deviation: 1.99; P = 0.04). Adherence to antibiotic prophylaxis was high for timing/selection/dose, but discontinuation beyond 24 hours and 7-day discharge prescriptions were common. Antibiotic consumption and costs were higher in SSI cases (355.9 vs. 280.5 DDD/100; 2807.6 vs. 2180 QR/100; P = 0.45; P = 0.72).

CONCLUSION

SSI incidence after abdominoplasty was modest but increased with combined procedures and poorer postoperative glycemic control. Strengthening perioperative glucose protocols and enforcing 24-hour prophylaxis limits may reduce SSI and unnecessary antimicrobial use and costs.