TEMPORAL VARIATION IN SURGICAL SITE INFECTION INCIDENCEAFTER EMERGENCY EXPLORATORY LAPAROTOMY: A PROSPECTIVECOHORT STUDY IN TWO HIGH-VOLUME TERTIARY HOSPITALS INKISUMU CITY, KENYA.

Abstract

Background: Surgical site infections (SSIs) continue to remain a major
healthcare burden, contributing to increased morbidity, mortality, and
prolonged hospital stays. While it has been hypothesized that nighttime
surgeries may carry a higher risk of complications, including SSIs, existing
evidence is mixed. This study aimed to assess the effect of the timing of
operation on SSI incidence among patients undergoing emergency
laparotomies in Kisumu City, Kenya.
Methods: A prospective cohort study was conducted among 145 patients at two high-volume public teaching hospitals in Kisumu County from January 29th, 2024 to January 29th, 2025. Descriptive statistics summarized demographic and clinical characteristics, while chi-square and Fisher’s exact tests assessed group differences. Relative risk (RR) and adjusted RR (aRR) were estimated using univariate and multivariate models with backward stepwise selection. All Analyses were performed using R and Stata.
Results: The overall incidence of SSI was 14.5%, higher following daytime
surgery (20.3%) compared to nighttime surgery (8.5%), although the difference was not statistically significant (RR 2.4, 95% CI: 0.99–5.84, p = 0.054).
Conclusion: Although SSIs were more frequent after daytime surgeries, the difference was not statistically significant, indicating that the time of operation may not independently predict SSI risk. The findings suggest that larger studies are needed to confirm the role of surgical timing in SSI incidence