BACKGROUND: Several interventions to reduce surgical site infection (SSI) have been designed and investigated. In spite of these, SSI remains the most common cause of Healthcare Associated Infections (HCAIs). In particular, contaminated and dirty abdominal wounds are attended by a high rate of SSI. This is associated with increase burden on both the patients and care givers such as extra cost of treatment and prolonged hospital stay. It was against this background that this study was designed to investigate the possible influence of the use of adhesive incise drape on SSIs in contaminated and dirty abdominal surgeries at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. OBJECTIVES: The aim of the study is to compare SSI in contaminated wounds and dirty wounds in adhesive incise drape versus conventional drape in adult surgical patients with acute generalized peritonitis at OAUTHC, Ile-Ife. METHODOLOGY: This was a prospective, comparative hospital based study conducted in the general surgery units of OAUTHC, Ile-Ife. Consecutive, consenting and eligible patients were randomized into two groups. In Group A patients, following skin preparation with savlon (containing 0.3% chlorhexidine and 3% cetrimide) and 70% alcohol antiseptic solutions, iodine impregnated adhesive incise drape (Ioban) which contain a PVP complex, N-vinyl-pyrrolidone, iodine (0.117-0.197 mg/cm2) yielding 1% available iodine, was applied to the abdomen, while Group B used only conventional drapes. Group A patients subsequently had their incisions made through the adhesive incise drapes while incisions were made through the skin in Group B patients. Further steps in each operation were continued as appropriate. Wounds were assessed for surgical site infection (SSI) on post-operative days 3, 7, 14 and 30 using the United States Centre for Disease Control and Prevention (CDC) criteria. Surgical site xiv infection rates were compared between the two groups. The grades of infection, microbial pattern of infected abdominal wounds and length of hospital stay were also compared between the two groups. Data obtained were analyzed by a computer software IBM (SPSS) statistics version 22. RESULTS Sixty two patients were recruited in this study, but only 55 patients completed the study as seven patients dropped out of the study because of early post-operative mortality. Out of the 55 patients who completed the study, 36 (65.5%) were males and 19 (34.5%) were females. The ages were ranged from 18 years to 78 years in group A and from 18 years to 74 years in group B. The mean age of patients in group A was 37.96 ± 19.59 years and that of group B was 36.74 ± 16.93 years. There was no statistically significant difference in the mean ages of the two groups (p=0.81). In this study, majority 36 (65.5%) of the participants were young adults of 40 years and below. Of those who completed the study, 28 patients were in Group A and 27 patients in Group B. Overall, 30 (54.5%) patients had surgical site infection (SSI) in this study. Thirteen (46.4%) patients had SSI in adhesive incise drape group while 17 (63%) patients had SSI in the conventional drape group. There was no statistically difference between the two groups (p=0.22). Evaluating the grades of SSI between the two groups showed that 10 (35.7%) patients in Group A had superficial SSI compared to 14 (51.9%) patients in Group B. Three (10.7%) patients in the adhesive incise drape group had deep SSI while two (7.4%) patients in the conventional drape group had deep SSI. These differences were not statistically significant (p=0.42). The most commonly isolated organism from infected wounds was Klebsiella species. Also, similar organisms were isolated from infected wound cultures, post skin preparation and peritoneal xv exudate in 19 (73.1%) cases. The isolated organisms were Klebsiella species, Staphylococcus species, Pseudomonas aurigenosa, Staphylococcus species, Proteus species, Escherichia coli species and Bacillus species.