Determinants of Surgical Site Infection After Emergency Abdominal Surgery at Teaching Hospitals in Rivers and Delta States

Surgical site infection after emergency abdominal surgery represents a major complication associated with prolonged hospitalisation, increased cost, and preventable mortality in South South Nigerian teaching hospitals. This study identifies the determinants of surgical site infection following emergency abdominal procedures at two teaching hospitals in Rivers State and Delta State over a three-year period. A retrospective cohort design is applied to records of 480 emergency abdominal cases, comparing those who developed surgical site infection against uninfected counterparts. Independent variables include CDC wound classification, diabetes mellitus, serum albumin at admission, preoperative antibiotic prophylaxis timing and compliance, operative duration, intestinal content spillage, drain insertion, and surgeon seniority. Cultures of wound swabs from infected cases are reviewed for pathogen profile and antibiotic sensitivity. Binary logistic regression in SPSS identifies independent predictors of surgical site infection. Available surgical infection literature from South South Nigeria identifies intestinal content spillage, prolonged operative duration, and hyperglycaemia as the most consistent independent risk factors, with Staphylococcus aureus and Escherichia coli as dominant pathogens. The CDC NHSN surgical site infection criteria guide case definition. Findings will support both institutions in developing a risk-stratified perioperative infection prevention bundle. Keywords: surgical site infection, emergency abdominal surgery, risk factors, South South Nigeria, perioperative infection.