Incidence and Determinants of Surgical Site Infections in Upper Limb Surgeries: A Multicentric retrospective cohort Study from Tertiary Referral Hospitals in Jordan

Background Surgical site infections (SSIs) are a major cause of complications during orthopedic surgeries. These infections increase the morbidity of patients. Although many studies have been conducted on SSI complications during lower limb surgeries, there is limited information on upper limb surgeries. Therefore, this paper sought to assess the incidence of SSI complications during upper limb surgeries and identify the associated risk factors. In addition, the impact of SSI complications was also assessed. Methods This was a retrospective cohort study conducted at a tertiary hospital from January 2024 to December 2025. In total, 546 patients who underwent upper limb surgeries were recruited into the study. Data was extracted from patients’ medical records and analyzed using IBM SPSS Statistics software. SSI complications were defined as superficial or deep wound infections. Descriptive, bivariate, and stratified incidence analyses of the data was conducted. In addition, Chi-square and independent t-tests were used to test the associations at a significance level of 0.05. Results The total incidence of SSI was 5% (n = 28). No significant correlation was noted between SSI and age (p = 0.62), sex (p = 0.19), duration of surgery (p = 0.54), and overall antibiotic use (p = 0.07). Significant correlations were observed between SSI and surgical factors, including type of surgery (p < 0.0001), surgery classification (p < 0.0001), and wound classification (p = 0.004). The highest incidence of SSI was noted in emergency procedures (7.7%) and open wounds (5.1%). A significant correlation was also found between the type of prophylactic antibiotic used and SSI occurrence (p = 0.04). SSI was not significantly associated with prolonged hospital stay (p = 0.12) or increased admissions (p = 0.71). Conclusion The present study indicates that SSI is an uncommon but clinically relevant complication in upper limb surgeries, with an overall incidence of 5%. Emergency procedures and open wounds were strongly associated with infection risk, while patient related factors such as age and sex, as well as surgical duration, were not significant predictors. Although SSI was not linked to prolonged hospital stay or increased admissions in this cohort, the type of prophylactic antibiotic demonstrated a significant association with infection occurrence. Keywords: Surgical site infection, upper limb surgery, orthopedic infections, incidence, risk factors, wound classification, prophylactic antibiotics