Factors associated with surgical site infection in appendectomies in a regional hospital

Abstract

Introduction. Acute appendicitis is one of the most common surgical emergencies. Despite technical advances, Surgical Site Infection (SSI) remains a prevalent complication that increases morbidity, mortality, and costs. Objective. To determine the incidence and pre- and intraoperative risk factors associated with the development of SSI in patients undergoing appendectomy and to evaluate its impact on hospital stay. Materials and Method. A retrospective cohort observational study of 137 patients who underwent emergency surgery at the Regional Hospital of Ciudad del Este (2022-2025). Demographic variables, comorbidities (diabetes, hypertension), surgical technique, and duration of the procedure were analyzed. Non-parametric statistics (Mann-Whitney U and Fisher's exact test) were employed with p < 0.05. Results. The overall incidence of SSI was 5,8% (n=8). Diabetes mellitus was clinically associated with a higher risk of infection (40% vs 4,5%; p = 0,061). The mean duration of surgery was longer in the infected group (84,5 vs 64,5 min; p = 0,068). No infections were recorded in the laparoscopic and mixed groups, compared to 8.3% in open surgery. SSI significantly prolonged hospital stays (median 4,0 vs 1,5 days; p < 0,001). Conclusion. SSI triples the hospital stay. While the overall incidence is acceptable, diabetes and prolonged surgical times emerge as critical risk factors that require strict monitoring. Laparoscopy proved to be a safe technique with a zero-infection rate in this cohort.