Background: Surgical site infection (SSI) is a common postoperative complication that causes significant morbidity and mortality, increases antibiotic usage, prolongs hospital stay, adds cost, and decreases pa­tients’ quality of life and has a high disease burden in developing countries.

Objectives: The purpose of this study was to assess the incidence of SSI and to identify risk factors for surgical site infection rate among clean open hernia repair.

Methods: Non-matched Prospective randomized study was conducted using pretested structured ques­tionnaire among 161 patients undergoing elective inguinal hernia repair at Jackson F. Doe Referral Re­gional Hospital, Lower Nimba/ Liberia from July 2016 to February 2017.

Results: With one month follow-up, there were 19 and 7 superficial and deep surgical site infections re­spectively making an overall surgical site infection rate of 26(16.15%) among the study groups, with the majority (88.46%) being detected postoperatively af­ter discharged. The rate of surgical site infection was analyzed by patient characteristics and peri-opera­tive variables. Analysis identified two from patient characteristics and three from peri-operative vari­ables correlating to the occurrence of SSI; Inguino-scrotal hernia (AOR=4.40, CI:1.44-13.48, p=0.009), Blood group AB (AOR=7.03, CI:1.35-36.65, p= 0.021), Povidone iodine for skin preparation (AOR=3.71, CI:1.09-12.61,p=0.035), duration of surgery >60 min(AOR=3.34, CI=1.25-8.96, p=0.017), Residents/ medical officer(AOR=4.57, CI:1.28-16.29, p= 0.019). The mean total hospital stay was also significantly longer in patients with wound infection (p=0.0001)

Conclusion: This study identified high rates of surgi­cal site infection. This study calls that all risk factors should be regarded as potential indicators of SSI and effective and relevant preventive measures should be taken to reduce SSI and improve outcomes.