Incidence and risk factors of surgical site infection in abdominal surgeries: A scoping review of cohort and case–control studies

AbstractBackground Abdominal surgery is considered a high-risk surgery for the development of surgical site infection. Few studies have evaluated the relative importance of its risk factors. Therefore, in this paper we mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of surgical site infections in abdominal surgery. Methods We searched SCOPUS, PubMed, and Web of Science databases up to March 16, 2023. Using the methodology of the Joanna Briggs Institute, we used both univariate and multivariate analysis results to evaluate the relative importance of the risk factors. Results Of 14,237 identified records, 107 articles were included in the review. The National Nosocomial Infection Surveillance (NNIS) risk index, operative time, and higher wound class were strong risk factors for surgical site infection incidence. Patients' educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were also the risk factors, but there is a need for more evidence to reach a conclusion. The pooled incidence of surgical site infections was 10.6% (95% CI 9.02–12.55) in abdominal surgery, and the type of surgical procedures accounted for 31.5% of the heterogeneity. Conclusion Our findings show that surgical site infection in abdominal surgery is a multifactorial phenomenon with a considerable risk and has different risk factors with various relative importance. Determining the relative importance of the risk factors for prevention and control of surgical site infection is strongly recommended. We provide some recommendations for future research.