Evaluation of Surgical Site Infection After Elective Surgeries at a Tertiary Care Hospital

Surgical site infections (SSI) are commonly seen in surgical practice and are the main cause for concern in post-operative patients. There are many risk factors that predispose to the development of SSI. However, the occurrence of SSI in patients undergoing elective class I and class II surgeries, which are considered clean surgeries with minimal contamination, is an important issue bothering the surgeons. SSI are also responsible for increased morbidity due to wound dehiscence, thus prolonging hospital stays and often leading to inconvenience to patients. We hereby present a study to highlight and address this important issue of SSI in our institute. All patients above 12 years of age who underwent elective class I and class II surgeries in the department of general surgery were included in this observational study. After surgery, local examination of the incision or wound site and grading of the SSI were done using the Southampton Wound Grading System (SWGS). Our results showed that 90% of the patients had normal healing, according to SWGS. We found that the incidence of SSI was lower in patients who underwent alternate-day dressing of their wound as compared to daily dressing. Another interesting finding was that the incidence of SSI was lower in patients in whom wound dressing was done with transparent film dressing as compared to povidone-iodine-guaze dressing. We concluded our study by finding that the incidence of SSI after elective class I and class II surgeries in our hospital was quite low, at 10%.

Dermatofibrosarcoma Protuberans: A Surgeon's Enigma

Dermatofibrosarcoma protuberans (DFSP) is a soft-tissue tumor arising from the dermis. It is a rare tumor, but the important point is that it has a higher incidence of local recurrence than other tumors. Management is primarily by wide local excision (WLE) with tumor negative margin (R0 resection) or Mohs micrographic surgery (MMS). In our case, a 57-year-old male patient presented with an anterior abdominal wall ulcerated mass. The patient had undergone surgery for the excision of the mass, twice before, at a different health-care facility. An incisional biopsy of the mass done at our hospital revealed it to be DFSP. The patient was treated by WLE with flap reconstruction. Post-operative histopathology examination (HPE) report confirmed DFSP with tumor-free margins (R0 resection). So if we fail to diagnose and manage DFSP correctly from the other commonly occurring tumors in the initial stages, there are very high chances of recurrence, and this causes significant morbidity to the patients.