A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiogram Proportions in Major Reconstructive Plastic Surgeries

International Journal of Medicine and Medical Sciences | Vol. 16, No. 2, February 2026 | pp. 9–16

DOI: 10.46882/2026/IJMMS/160009

Original Research Article

A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiogram Proportions in Major Reconstructive Plastic Surgeries

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Surgery, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Surgical site infections (SSIs) following complex reconstructive plastic surgeries compromise aesthetic outcomes, increase healthcare costs, and risk tissue flap necrosis. This retrospective clinical study evaluated the overall prevalence, specific risk factors, and microbiological resistance trends of SSIs following elective tissue flap reconstructions and major scar revisions over a five-year period (2021–2025). De-identified medical charts of 450 patient files were extracted and analyzed using the Centers for Disease Control and Prevention (CDC) wound criteria. Out of the 450 procedures reviewed, 28 cases of confirmed SSIs were identified, resulting in an overall prevalence rate of 6.22%. Staphylococcus aureus was the predominant bacterial pathogen isolated from wound site swabs (39.3%), with 36.4% of these strains confirmed as methicillin-resistant (MRSA). Gram-negative bacilli, led by Pseudomonas aeruginosa, accounted for 28.6% of infections. Antibiogram mapping revealed high resistance rates among Gram-negative isolates to amoxicillin-clavulanic acid (82.1%) and ceftriaxone (64.3%), while all strains remained susceptible to amikacin and imipenem (100%). Multivariate logistic regression analysis demonstrated that an operative duration > 180 minutes (OR = 3.4, 95% CI = 1.8–6.4, p < 0.01), pre-existing obesity with a BMI ≥ 30 kg/m² (OR = 2.8, p < 0.05), and tobacco smoking (OR = 2.4, p < 0.05) were independent predictors of SSI. Post-reconstructive SSIs present notable clinical challenges due to resistant pathogens, highlighting the need to enforce perioperative prophylactic measures and maintain strict aseptic handling of tissues.

Keywords: Surgical Site Infection, Plastic Surgery, Staphylococcus aureus, MRSA, Antibiotic Resistance, Risk Factors

Manuscript Timeline: Received: November 11, 2025; Revised: December 18, 2025; Accepted: January 10, 2026; Published: February 18, 2026.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiogram Proportions in Major Reconstructive Plastic Surgeries. International Journal of Medicine and Medical Sciences, 2026, 16(2): 9–16. DOI: 10.46882/2026/IJMMS/160009

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