BACKGROUND:
Surgical site infection is one of the most common complications following caesarean section. Incidence of wound infection ranges from 0.5% to 15%. Post caesarean wound infection is a major cause of prolonged hospital stay, increases maternal morbidity and increased medical costs which poses a significant burden to health care system. Caesarean section is a clean contaminated type of surgery where procedure related chance of infection is less. Hence proper assessment of risk factors that predisposes to SSI is critical for developing preventive strategies.
AIM AND OBJECTIVE:
The aim of the study is to determine the incidence of post caesarean surgical site infection, to identify the risk factors, common bacterial pathogens causing infection and to analyze antibiotic sensitivity.
MATERIALS AND METHODS:
Study Centre: Department of Obstetrics and Gynaecology, Government Raja Mirasudhar Hospital, Thanjavur Medical College.
After obtaining approval by the ethical’s committee and getting written informed consent from all patients, a prospective cohort study conducted over a period of 12 months from January 2018 to December 2018. All women undergoing caesarean sections in Raja Mirasudhar Hospital will be evaluated in the study to identify the patients who are developing any form of wound infection within 30 days from the date of caesarean section.
RESULTS:
Out of 6211 patients who underwent patients, 92 had developed wound infection. The incidence of wound infection in the present study was 1.48%.The rate of wound infection in emergency LSCS was 1.2%, whereas elective was only 0.2%. The various risk factors associated with the wound infection in my study were Anemia (71.7%), HTN (35.9%), Diabetes (7.6%), and PROM (16.3%) Handled outside (7.6%) Anemia and Diabetes increases the risk of wound infection by 2.5 times ant 2 times respectively. Lower socioeconomic status BMI > 26 is found to be the significant risk factor. Number of PV examinations more than 4 was found to be significant risk factor for wound infection. P The most common organism isolated in my study was S.Aureus followed by E-Coli and S.aureus is most sensitive to linezolid. Only 42% of patients went for secondary wound resuturing and other patients were treated using local wound care and higher antibiotics.Wound infection leads to significant extension of hospital stay in 87% of patients.
CONCLUSION:
The incidence of wound infection in my study was 1.48%. We conclude that Anemia, Diabetes, PROM, Handled outside, multiple per vaginal examinations, prolonged induction are predominant risk factors leading to wound infection. We also found that wound infection leads to significant extension of hospital stay. Strategies for prevention of this morbidity must aim to correct anemia, to avoid prolonged hospital stay prior to delivery ,to correct maternal comorbidities prior to surgery and Strict adoption of asepsis. SSI surveillance must be done as a part of HAI audit which aims at improving Quality control measures and infection control practices
