Post operative wound gape in obstetric and gynaecological surgeries

Background: Despite advances made in asepsis, post operative wound infection is one of the major causes for increased postoperative morbidity and huge economic burden for patient and healthcare. This study was undertaken to identify risk factors for the post operative wound gaping in obstetrical and gynaecological surgeries. Methods: Retrospective observational study was conducted in the department of obstetrics and gynaecology of Pt. Madan Mohan Malviya Shatabdi hospital, Govandi, Mumbai for the year 2022. Results: 1611 cases were analysed that underwent various obstetrical and gynaecological surgeries. Post operative wound gaping incidence was 1.5 %. Most of the cases were seen in less than 34 years of age. 21% of cases reported with wound gaping and discharge within 5-7 days of surgery while 79% of cases reported gape after 7 days of surgery. 54% cases with wound gape were obstetric. The most commonly known associated risk factor was found to be diabetes mellitus (12.5%) followed by anaemia (8.3%), obesity (4.2%) and hypertension (4.2%). 62.49% of post operative surgical wound gape were multiparous. It is seen that in all these cases of wound gape the subcutaneous tissue was sutured separately as a layer with absorbable suture material- Vicryl no 1-0 or Vicryl no 2-0. Conclusions: Factors affecting post operative wound gaping are diabetes mellitus, anaemia, hypertension, obesity, chemoprophylaxis given prior to surgery, surgical method of wound closure and type of surgery. Standard wound closure techniques, correction of the avoidable known risk factors would provide a better outcome

A retrospective study to analyse the rate of caesarean section according to Robson's 10 group classification in a peripheral hospital in a metropolitan city

Background: In the past several decades, a pattern of rapid increases in Caesarean section (CS) delivery rates has been observed worldwide, as also in India. It is important to identify the reason behind the rising rates of CS since they can pose unnecessary risks to the mother and the neonate. The aim of the study was to analyse the CS rate in the ten groups as per Robson’s ten group classification, in a peripheral hospital in a metropolitan city. By this study we have tried to identify specific groups of women to be targeted to reduce CS rates.Methods: This is a retrospective study carried out at a peripheral hospital in Mumbai, India. It included all women who had delivered in the hospital from January, 2019 to December, 2019. The sample size was 2603.Results: Under this study, we found out that the rate of CS delivery is higher than what is recommended by WHO in Robson’s group 2, 5 and 6.Conclusions: This study will help us carry out targeted interventions so as to reduce the CS rates in these groups