Occurrence, Management and Complications of Surgical Site Infections in Emergency vs Elective Exploratory Laparotomy

Surgical site infection; exploratory laparotomy; emergency surgery; elective surgery; antibiotic resistance; postoperative complications.

Dr Ravi Goyal,
Associate Professor,
Department of General Surgery, Smt. B.K.
Shah Medical Institute and Research Centre,
Sumandeep Vidyapeeth, Piparia, Vadodara391760, Gujarat, India.

Dr Honeypalsinh H. Maharaul,
Associate Professor, Department of General Surgery,
Smt.B.K. Shah Medical Institute and Research
Centre, Sumandeep Vidyapeeth, Piparia,
Vadodara-391760, Gujarat, India.

Dr Ohang Chaudhari,
Professor, Department of General Surgery,
Smt. B.K. Shah Medical
Institute and Research Centre, Sumandeep
Vidyapeeth, Piparia, Vadodara-391760, Gujarat, India.

Dr Varad Rathod,
Postgraduate Resident,
Department of General Surgery, Smt. B.K.
Shah Medical Institute and Research Centre,
Sumandeep Vidyapeeth, Piparia, Vadodara391760, Gujarat, India.

Dr Sanchit Sanghai,
Postgraduate Resident,
Department of General Surgery, Smt. B.K.
Shah Medical Institute and Research Centre,
Sumandeep Vidyapeeth, Piparia, Vadodara391760, Gujarat, India.

Dr Vipul Gurjar*,
Department of General
Surgery, Smt. B.K. Shah Medical Institute and
Research Centre, Sumandeep Vidyapeeth,
Piparia, Vadodara-391760, Gujarat, India.
Email: [dr.vipulgurjar@yahoo.com]
Phone: [9825070800]

Received:20-06-2026
Revised:24-07-2026
Accepted:05-08-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34(7s), 927–932

Occurrence, Management and Complications of Surgical Site Infections in Emergency vs Elective Exploratory Laparotomy

Background: Surgical site infections are among the most common healthcare-associated infections worldwide and disproportionately affect patients undergoing emergency laparotomy. Objective: To evaluate and compare the occurrence, microbiological profile and outcomes of SSIs following emergency versus elective exploratory laparotomy. Methods: This prospective observational study was conducted in the Department of General Surgery, Dhiraj General Hospital, India, between November 2023 and March 2025. 102 patients undergoing exploratory laparotomy were enrolled (elective n = 61, 59.8%; emergency n = 41, 40.2%) and followed for 30 postoperative days. SSIs were classified using CDC criteria (1,2). Categorical variables were compared by chi-square test, continuous variables by independent-sample t-test. Results: Mean age was comparable (45.84 ± 15.07 vs 48.00 ± 18.59 years; p = 0.519). Males were more frequent in emergency cases (80.5% vs 57.4%; p = 0.015). Diagnoses differed significantly (p = 0.002), intestinal perforation (26.8%) and gastrointestinal perforation (17.1%) predominating in emergency cases. Alcohol use was significantly more common in emergency patients (19.5% vs 4.9%; p = 0.015). The overall SSI rate was 28.4%, markedly higher in the emergency group (41.5%) than the elective group (19.7%; p = 0.017). Escherichia coli was the most frequently isolated organism in both groups (33.3% vs 47.1%); the microbiological distribution (p = 0.824) and antibiotic responsiveness (p = 0.367) did not differ significantly between groups. Conclusion: Emergency exploratory laparotomy is associated with markedly elevated SSI risk compared with elective procedures. Microbial profiles and antibiotic responsiveness are comparable, indicating prevention - not antimicrobial modification — is the principal modifiable lever.

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