Surgical site infection in obstetrics practice

ABSTRACT

To determine the frequency of surgical site infection [SSI], the etiological factors and its management in elective and emergency cesarean sections. Observational study. Department of Obstetrics and Gynaecology, Islam Teaching Hospital Sialkot, from September 2010 to October 2012. Five hundred patients undergoing elective/emergency cesarean section for various indications were included. A minimum follow-up of three months was made. The patients were divided into two groups. Group -1, comprised of 267 [53%] cases of elective cesarean sections, while in group -2, 233 [47%] cases who were non-booked and presented in emergency, were included. The standard preoperative assessment was done in both the groups.The surgical aseptic technique was same in both the groups including antibiotic prophylaxis. All the patients were admitted for at least 5 days postoperatively and dressings changed on 3[rd] postoperative day and on 5[th] day before being discharged. The follow-up was done on 8-10[th] day including assessment for surgical site infections. A total of 29 [5.8%] patients had surgical site infection. The frequency of surgical site infection in group -1 was 4.8% [n=13] and in group - 16.8% [n=16]. Of the total twenty nine cases of SSI in both the groups, 20 [68%] were superficial in nature, 6 [21%] deep and 3 [10%] occurred in organs/body cavities. Escherichia coli was the most common organism isolated [n=12 - 48%] followed by Staphylococcus aureus in 6 [24%] cases. All the cases of wound infection were noted on outdoor visits i.e. after a week or so of surgery. Length of stay and duration of surgery were found to be minor risk factors responsible for causing surgical site infection