ABSTRACT
Background: Surgical site infection (SSI) can be defined as infections which develops within 30 days after surgery involving the skin and subcutaneous tissue of the incision and/or the deep soft tissue and/or any part other than the incision handled during surgery. This study has been taken up to determine the incidence of SSI in abdominal surgery and to determine factors responsible for its occurrence.Methods: The study was conducted in Dr. D.Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective longitudinal descriptive study. Information collected from the patients included patient’s age, gender, diabetes mellitus status, smoking status and haemoglobin and albumin levels.Results: Total 150 cases with abdominal operations were included in this study. Among them 29 patients developed SSI. Incidence of SSI among them was 19.3%. There was no significant difference among gender between both the groups. (p=0.172). Among 29 SSI cases, 10 (34.5%) had diabetes while 19 (65.5%) did not have diabetes. There was significant difference in diabetes status between both the groups (p=0.021). Patients having diabetes has more risk of getting SSI post operatively. Among 29 SSI cases, 8 (27.6%) were smokers while 21 (72.4%) were non-smokers.Conclusions: The incidence of SSI among cases underwent abdominal surgery was 19.3%. In our institute where most patients come from low economic state, poor hygiene and nutrition status, with current preoperative protocol for SSI prevention SSI rate is comparable to that of most developing countries.
ABSTRACT
Background: Management of health-care waste is an essential task, which has important consequences for public health and the well-being of society. Economic evaluation is important for strategic planning and investment programming for health-care waste management (HWM). A cost–benefit analysis of an alternative method of HWM in Bir hospital, Nepal was carried out using data recently collected from primary sources. Methods: Data were collected using mixed quantitative and qualitative methods. Costs and benefits were measured in Nepalese rupees. The values of all inputs were costs associated with the alternative HWM. Benefits were defined as the reduction in cost of transportation; money obtained from selling of recycled waste; and risk reduction, among others. Break-even analysis and calculations of benefit– cost ratio were used to assess the alternative HWM. Results: The alternative HWM reduces the cost of waste disposal by almost 33% per month, owing to reduction in the amount of waste for disposal. The hospital earns 3 Nepalese rupees per bed per day. The results suggest that a break-even point for costs and benefits occurs when 40% of the total beds of the hospital are covered by the alternative HWM, if the bed occupancy rate is at least 68%. If the alternative HWM is introduced in the hospital system, hospitals can reach the break-even point at 40 to 152 beds, depending on their performance in HWM. Conclusions: The results show the economic feasibility and financial sustainability of the alternative HWM. This alternative method of HWM is a successful candidate for replication in all public and private hospitals in Nepal.