Role of Serum Procalcitonin in Early Detection of Surgical Site Infections Clean Surgical Cases: A Diagnostic Study

Background: Surgical site infections (SSIs) are a major cause of postoperative morbidity, necessitating reliable and early diagnostic tools. Serum procalcitonin (PCT) has emerged as a potential biomarker for the early detection of bacterial infections, which include SSIs, due to its rapid response to systemic inflammation. Objective: This study aimed to evaluate the diagnostic accuracy of serum PCT in the early detection of SSIs in patients undergoing clean elective surgeries. Methods: A prospective diagnostic study was conducted in the Department of General Surgery, JSS Medical College, Mysore, over 1.5 years (August 2022 to December 2023). A total of 102 patients undergoing clean elective surgeries were enrolled through simple random sampling. Serum PCT levels were measured on postoperative day 2 (POD2) using the Enzyme-Linked Fluorescent Assay (ELFA). Patients with PCT levels exceeding 0.86 ng/mL were further evaluated with culture and sensitivity tests. The patients who had SSI were followed up for a period of 30 days. Diagnostic accuracy was assessed using Area Under the Curve (AUC) analysis, sensitivity and specificity were calculated. Results: SSIs were diagnosed in 2% of patients. Elevated PCT levels (>0.86 ng/mL) demonstrated a sensitivity of 100% and specificity of 99.9% for early SSI detection, with an AUC of 0.995. Conclusion: Serum procalcitonin is a highly accurate biomarker for the early detection of SSIs, with strong sensitivity and specificity. Its incorporation into routine postoperative monitoring can improve early diagnosis and enhance patient outcomes.