SRS101 - A closed loop audit assessing the rate of surgical site infections after wound closure with sutures in Major Lower Limb Amputations

Abstract Introduction Major lower limb amputations (MLLA) are a last resort treatment for patients with peripheral arterial and diabetic foot disease. A significant number of patients subjected to MLLAs will develop a surgical site infection (SSI), which can have an impact on patient morbidity and mortality. This audit, based in a single Vascular centre, aimed to assess whether the materials that MLLA skin wounds were closed with are an associated risk factor for SSIs. Methods A closed-loop audit was carried out by retrospectively looking at the notes of all patients who had undergone MLLA between August 2022 to January 2023. The material used to close skin was identified for all patients, as was the presence of any SSI. The data was presented at a local audit meeting and a re-audit was carried out 6 months later. Results A total of 64 patients were included. In the first cycle, the SSI rate was 40% (10/25), with staples being statistically significant (Fischer exact test value: 0.0027, P < 0.05) at increasing the infection rate. Following the second cycle, the SSI was 10.2% (4/39), with sutures being statistically significant (Fischer exact test value: 0.0154, P < 0.05) at reducing the infection rate. Of the risk factors that were analysed, none were statistically significant between the two groups of patients. Discussion Closing MLLA wounds with sutures rather than staples appears to reduce the rate of SSI. Due to the low sample size, this audit cannot exclusively show that closing MLLA with staples increases the risk of infection.