The Incidence and Distribution of Surgical Site Infection in Mainland China: A Meta-Analysis of 84 Prospective Observational Studies

Surgical site infection (SSI) is one of the most common surgical complications in the world, particularly in developing countries. This study aimed to estimate the incidence and distribution of SSI in mainland China. Eighty-four prospective observational studies (82 surveillance studies, 1 nested case control study, and 1 cohort study) were selected for inclusion in this meta-analysis. The average incidence of SSI in mainland China was 4.5% (95% CI: 3.1-5.8) from 2001 to 2012 and has decreased significantly in recent years. The remote western regions had a higher incidence of 4.6% (95% CI: 4.0-5.3). The most common surgical procedure was abdominal surgery (8.3%, 95% CI: 6.5-10.0). SSI occurred frequently in the elderly (5.1%, 95% CI: 2.2-8.0), patients confined to hospital for over 2 weeks (5.7%, 95% CI: 0.9-10.0), superficial incision wounds (5.6%, 95% CI: 4.4-6.8), dirty wounds (8.7%, 95% CI: 6.9-10.6), operations lasting for over 2 hours (7.3%, 95% CI: 4.9-9.7), general anaesthesia operations (4.7%, 95% CI: 2.7-6.6), emergency surgeries (5.9%, 95% CI: 4.2-7.7), and non-intra-medication operations (7.4%, 95% CI: 1.0-13.7).