Impact of Pre-Existing Infections on Surgical Site Infection Risk: Evidence from 769 Elective Surgeries

Abstract

Background: Surgical site infections (SSI) remain a major source of morbidity and mortality in surgical patients worldwide. While many risk factors are well established, the influence of prior infections and past wound-healing complications remains considerable but underexplored. Objective: To investigate the association between pre-existing infections, history of wound infection or delayed healing, and the risk of SSI in a patients undergoing elective surgery. Methods: A cross-sectional study was conducted on 769 patients undergoing elective surgery at the Trauma University Hospital, Tirana. Data included demographics, presence of active infections elsewhere in the body, history of prior surgical wound infection or delayed healing, and postoperative SSI outcomes. Logistic regression was applied to identify independent predictors of SSI. Results: The mean patient age was 50.2 years (±18.7), with a nearly equal sex distribution (51.1% male, 48.9% female). Almost half of the patients were recruited from orthopedics (48.6%), followed by general surgery (41%). Only 0.7% (n=5) reported an active infection at the time of surgery, while 7.4% (n=57) reported a history of wound infection or delayed closure after previous surgeries. Multivariate analysis revealed that the presence of an active infection significantly increased the risk of SSI (OR=7.966), and a history of wound infection/delayed healing was also an independent predictor (OR=3.608). Conclusion: The presence of prior or concurrent infections markedly increases the risk of SSI, and adequate preoperative assessment, eradication of active infections, and detailed surgical history should be integrated into standard SSI prevention strategies.