{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T09:34:41Z","timestamp":1786872881897,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Aga Khan Student and Trainee Initiated Research Programme","award":["MBBS Class of '88 Awards, Aga Khan University"],"award-info":[{"award-number":["MBBS Class of '88 Awards, Aga Khan University"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,28]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgical site infections (SSIs) are among the the most common postoperative complications, despite being highly preventable. Multiple studies have explored the incidence and risk factors of SSIs globally. However, nationally representative data capable of informing evidence-based guidelines remain limited in Pakistan. Hence, the aim of this study is to identify the incidence and risk factors of developing SSIs following surgery and to explore existing SSI prevention practices in Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study is a multicentre, prospective cohort study across various sites in Pakistan. All consecutive adult patients undergoing inpatient elective surgery in a 1\u2009month patient recruitment window from one or more of the nine eligible subspecialties will be included in the study. Patients with preoperative infections, emergency surgeries or intraoperative mortality are to be excluded. The following surgical subspecialties are included: breast surgery, cardiac surgery, colorectal surgery, cranial surgery, general surgery, obstetrics and gynaecology, orthopaedics surgery, spine surgery and vascular surgery. Each mini-team of up to three collaborators can select one of the nine subspecialties and a 1\u2009month patient recruitment window from 20 September 2022 to 31 March 2023. Multiple mini-teams from the same sites can recruit patients across the same subspecialty in distinct patient recruitment windows. Additionally, multiple mini-teams from the same sites can recruit patients across different subspecialties in the same or distinct patient recruitment windows. The primary outcome is 30 day SSIs. Secondary outcomes include 30 day antibiotic-resistant SSIs, organ-space infections, other healthcare associated infections, reinterventions and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Approval was received by the Aga Khan University (AKU) Ethics Review Committee (ERC) and the National Bioethics Committee (NBC) Pakistan. The results from this study will be disseminated by the steering committee in journal publications, conference presentations and on other academic platforms. Evidence-based guidelines that result from these data will be disseminated to all surgical care providers in Pakistan through national networks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070831","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T13:10:31Z","timestamp":1690290631000},"page":"e070831","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["PakSurg 1: determining the epidemiology and risk factors of surgical site infections in Pakistan\u2014a multicentre, prospective cohort study"],"prefix":"10.1136","volume":"13","author":[{"name":"PakSurg Collaborative","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,25]]},"reference":[{"key":"2025121407411137000_13.7.e070831.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61458-4"},{"key":"2025121407411137000_13.7.e070831.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.03.021"},{"key":"2025121407411137000_13.7.e070831.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30101-4"},{"key":"2025121407411137000_13.7.e070831.4","article-title":"Frequency of post-operative surgical site infections in a tertiary care hospital in abbottabad, Pakistan","volume":"11","author":"Sattar","year":"2019","journal-title":"Cureus"},{"key":"2025121407411137000_13.7.e070831.5","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1089\/pop.2014.0099","article-title":"Health care coverage decision making in low- and middle-income countries: experiences from 25 coverage schemes","volume":"18","author":"Gutierrez","year":"2015","journal-title":"Popul Health Manag"},{"key":"2025121407411137000_13.7.e070831.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.04.004"},{"key":"2025121407411137000_13.7.e070831.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30402-9"},{"key":"2025121407411137000_13.7.e070831.8","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.088179"},{"key":"2025121407411137000_13.7.e070831.9","doi-asserted-by":"publisher","DOI":"10.1086\/670626"},{"key":"2025121407411137000_13.7.e070831.10","first-page":"99","article-title":"Incidence and predictors of infection in patients undergoing primary isolated coronary artery bypass grafting: a report from a tertiary care hospital in a developing country","volume":"52","author":"Ahmed","year":"2011","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"2025121407411137000_13.7.e070831.11","first-page":"15","article-title":"Rate and risk factors for surgical site infection at a tertiary care facility in peshawar, Pakistan","volume":"23","author":"Khan","year":"2011","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"2025121407411137000_13.7.e070831.12","unstructured":"Sharif AM , Jabeen DF , Ali LA , et al . n.d. Surgical site infection in elective surgery."},{"key":"2025121407411137000_13.7.e070831.13","first-page":"269","article-title":"Assesment of predictor variables and clinical consequences associated with surgical site infection in tertiary care setting, Karachi, Pakistan","volume":"31","author":"Tariq","year":"2018","journal-title":"Pak J Pharm Sci"},{"key":"2025121407411137000_13.7.e070831.14","unstructured":"World Health Organization . Global guidelines for the prevention of surgical site infection, second edition. World Health Organization 2016:27\u201337."},{"key":"2025121407411137000_13.7.e070831.15","unstructured":"CDC . Chapter 9: surgical site infection (SSI) event-January 2023. 2023."},{"key":"2025121407411137000_13.7.e070831.16","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S177247"},{"key":"2025121407411137000_13.7.e070831.17","unstructured":"WHO . n.d. 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