Risk factors for surgical site infection following gynecological surgery in a tertiary maternal and child health hospital

Objective The aim of the study was to determine the incidence of surgical site infection (SSI) and identify associated risk factors among patients undergoing gynecological surgery at a tertiary maternal and child health hospital. Methods This retrospective cohort study included 248 patients who underwent gynecological surgery in 2025. Healthcare-associated infections (HAIs) were identified through electronic surveillance and medical record review. Risk factors for SSI were evaluated using univariate analysis and multivariable logistic regression. Model performance was assessed using bootstrap validation. Results SSI occurred in 24 patients (9.68%), accounting for over 75% of identified HAIs. The incidence was higher in patients with type II than type I incisions (12.00% vs. 4.11%, P = 0.044) and in those with a National Nosocomial Infections Surveillance risk index of 1 vs. 0 (26.67% vs. 4.26%, P < 0.001). Multivariable analysis identified underlying comorbidities [odds ratio (OR) = 3.28, 95% confidence interval (CI): 1.27–8.48] and operative duration (OR = 1.015 per minute, 95% CI: 1.008–1.022) as independent risk factors. The model demonstrated good discrimination (AUC = 0.839; optimism-corrected AUC = 0.833). Non-compliance with prophylactic antibiotic timing was associated with increased SSI risk in an unadjusted sensitivity analysis (OR = 4.16, 95% CI: 1.25–13.89), although timing could not be verified in 13.3% of patients. Conclusion SSI was the predominant HAI following gynecological surgery. Underlying comorbidities and prolonged operative duration were independently associated with SSI, highlighting the importance of preoperative risk assessment and optimized perioperative management. Larger prospective studies are warranted to validate these findings.