Study of incidence and risk factors of surgical site infections in lower segment caesarean section cases of tertiary care hospital of north India.

OBJECTIVES: To determine the incidence density, risk factors and common pathogens associated with surgical site infections (SSI) following lower segment caesarean section (LSCS) surgeries. METHODS: In this Non-interventional prospective observational study, a total of 611 post caesarean emergency and elective cases were enrolled among the 1018 LSCS cases conducted for the period of May-August 2016. The demographic, risk factors and clinical data for appearance of signs and symptoms of SSI were recorded in a preformatted proforma. SSI's were classified as superficial, deep and organ space as per Centre for Disease Control (CDC), USA definitions. Pus specimens were processed and antimicrobial susceptibility results of the organisms were determined as standard microbiological techniques. RESULTS: The SSI rate was found to be 10.3 per 100 surgeries in our study with superficial SSI (66.7%) being most common. Inappropriate pre-surgical antibiotic prophylaxis, anaemia, previous LSCS as indication of LSCS, intra-operative blood transfusion and comorbid illness like heart disease, hypothyroidism, chronic liver and kidney disease were found to be significantly associated with SSI. Predominance of gram negative isolates (55.3%) was seen in comparison to gram positive isolates (44.7%) as cause of surgical site infections. CONCLUSIONS: SSIs rates observed are much higher than those observed in NHSN participating hospitals. Many of the risk factors identified are low hanging fruits and can be targeted to effectively reduce SSI rates.

Nano-silver hydroxyapatite based antibacterial 3D scaffolds of gelatin/alginate/poly (vinyl alcohol) for bone tissue engineering applications.

In the present study macroporous three dimensional spongy scaffolds composed of gelatin, alginate, and poly (vinyl alcohol) were prepared by cryogelation technique and silver hydroxyapatite was reinforced into the 3 D matrix. The polymer nanocomposite materials were characterized by analytical techniques such as Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and x-ray diffraction (XRD) analysis. The nanocomposite scaffolds were studied for their porous nature, water sorption capacity, and mechanical behavior. The suitability of scaffolds for bone tissue engineering applications was judged by evaluating their antibacterial and cytotoxic nature against gram positive and gram negative bacteria, and MC3T3-E1 preosteoblast cells, respectively. The scaffolds were also studied for release of silver ions and the influence of various experimental conditions on the release profiles of silver ions was investigated.