Post operative wound infection: a descriptive study

Background: Surgical site infections is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as the patient. This study was designed to evaluate the frequency, clinical presentation, common risk factors and different organisms involved.Methods: This study was performed at NRI Medical college, Chinnakakani. This is an Observational descriptive study over a period of one year from September 2022 to September 2023. Biodata of the patients together with their clinical features, diagnosis, type of surgery performed and the development of any complications including wound infection was noted and the data analyzed.Results: Out of 1509 patients in the study, 1101 belonged to obstetrics and 408 to gynaecology surgery. The overall incidence of surgical site infection in the study was 7.9%; 86 (7.8%) in obstetrics group and 33 (8%) in gynaecology group developed infection. Age more than 50 years was found to be a risk factor for postoperative wound infection. Obesity is known to be a well-established risk factor for postoperative wound infection. It was noted that surgical site infection was more common in patients that had low haemoglobin levels pre-operatively. The increased susceptibility to infection in diabetics is an established risk factor.Conclusions: Meticulous surgical technique, proper sterilization, judicious use of antibiotics, improvement of ward environments, control of malnutrition and obesity, treatment of infective foci and diseases like diabetes helps control the morbidity of surgical wound infections.

Instrumental deliveries and its outcome in tertiary care center

Background: Objective of the study was to determine the incidence and indication of assisted vaginal deliveries and to compare the fetal and maternal outcome of vacuum and forceps deliveries.Methods: This study done over a period of one and half year from March 2022 to August 2023 at NRI Medical College, Chinnakakani. Total number of vaginal deliveries are 1617, out of which 33 had a successful assisted vaginal delivery and studied in terms of maternal and fetal outcome. Verbal consent was taken, indication for instrumental application documented and pre requisites fulfilled before instrument application.Results: Out of 1617 vaginal deliveries in our institute, 33 cases successful underwent assisted vaginal deliveries in which 49% were vacuum assisted, 51% were forceps assisted deliveries. Most common indication for instrument application were fetal distress (51%), failure of maternal forces followed by maternal exhaustion (30%). We had 2nd degree perineal tear - 2 (11.76%), cervical tear - 1 (5.88%), PPH-1 (5.88%), 1- vaginal laceration (6.25%) as maternal complications. Out of 16 vacuum and 17 forceps deliveries, 5/16 (31.25%) and 8/17 (47.06%) were admitted in NICU respectively.Conclusions: In the present study showed that most common indication for assisted vaginal deliveries are fetal distress and maternal exhaustion. Maternal complications are seen more in forceps deliveries when compared to vaccum. There is no significant difference between vaccum and forceps deliveries in neonatal complications when compared.