Surgical site infections (SSIs) are defined as infections that develop at or near the surgical incision after surgery. They can affect the skin, subcutaneous tissue, deeper soft tissues, or any implanted material [1]. The causative pathogens often originate from the patient’s endogenous flora. The specific organisms involved typically depend on the type and location of surgery; the most common are Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp., and Escherichia coli [2]. The primary sources of infection are the patient’s skin and, less frequently, the gastrointestinal or genital tracts [3].

The development of an SSI involves a complex interaction of factors, including the nature of the surgical procedures, patient-specific variables (e.g. age, immune status, comorbidities), and environmental factors within the hospital setting [4]. SSIs are a major global healthcare concern, affecting millions of patients annually and representing the second most common type of healthcare-associated infection [5]. They impose a substantial economic burden due to extended hospital stays, readmissions, additional surgical procedures, and long-term antibiotic therapy, further exacerbated by indirect costs from lost productivity and disability [6]. Despite advances in aseptic techniques, surgical methods, and infection control, SSIs remain a persistent challenge [7]. In low-resource settings, they are notably prevalent, affecting a significant proportion of surgical patients [8]. According to the World Health Organization (WHO), risk factors associated with SSIs include both non-modifiable factors s(e.g. age and gender) and modifiable factors (e.g., nutritional status, smoking, intraoperative techniques), the control of which can significantly improve patient outcomes [9].

Existing literature reveals significant knowledge gaps among healthcare professionals. According to a study conducted at King Abdulaziz University Hospital in Saudi Arabia, physician knowledge of surgical site infections (SSIs) was found to be insufficient. While (25.2%) of physicians were aware of SSI incidence rates, only (6.7%) possessed good overall knowledge, highlighting a substantial deficit in understanding key SSI indicators [9]. A 2022 cross-sectional study in Riyadh, Saudi Arabia, found that only (6.7%) of physicians had good knowledge of SSIs, while (63%) had fair knowledge and (30.2%) had poor knowledge [10]. Similarly, a 2023 study in Makkah, Saudi Arabia, reported that merely (4.1%) of participants had good knowledge, with over half (55.7%) possessing only moderate understanding [11].

A comprehensive review concluded that despite generally positive attitudes towards SSI prevention, healthcare professionals often have poor knowledge of SSI prevention [12]. This gap between knowledge and practice was highlighted in a study at a tertiary trauma center, which emphasized the need for more targeted training [13]. A 2025 systematic review and meta-analysis highlight the variability in healthcare professionals’ knowledge, revealing that (62%) of nurses demonstrated good knowledge of SSI prevention when assessed dichotomously, a figure which fell to (46%) on a three-point Likert scale [14]. This inconsistency underscores a significant gap that can directly impact clinical practice. Fortunately, evidence from a 2023 interventional study confirms that structured educational programs can substantially improve HCPs’ knowledge and skills in SSI detection and prevention [15].

This study aims to alleviate the burden of SSIs in Sudan. The findings will be essential for developing targeted interventions, such as policy revisions and educational initiatives—including face-to-face sessions and poster campaigns, which have proven effective [16]. Given that approximately half of all SSIs are considered preventable through evidence-based strategies [17], there is a clear imperative for such actions. Ultimately, this study will provide valuable insights for policymakers, healthcare providers, and researchers, fostering a collaborative effort to reduce SSI incidence and improve surgical care quality in Sudan.