INCIDENCE AND RISK FACTORS OF SURGICAL SITE INFECTION FOLLOWING CESAREAN SECTION IN A TERTIARY CARE CENTRE IN NORTH KERALA, INDIA
Keywords:Surgical site infection, Caesarean, Risk factors, Incidence, Labor -related, Surgical -site infection
Objectives: To objectives of the study were to study 1) the incidence and maternal determinants (host related) risk factors on post cesarean surgical site infection (SSI) and 2) the influence of labor related and procedure related risk factors on post cesarean SSI.
Methods: This study was conducted in the Department of Obstetrics and Gynaecology, KMCT Medical College, Kozhikode from April 1 to August 31 2021 after clearance from ethical committee in which 153 cases of SSI post cesarean were included in the study.
Results: Educational status of patients had statistically significant association with the development of SSI incidence of SSI (44.4%) and is highest among overweight women. Patients with diabetes and hypertension had increased risk of developing SSI. 72.2% with SSI had duration of ruptured membrane for >8 h and duration of rupture of membrane were significantly associated with development of wound infection. Significant linear association was found between number of prior cesarean and risk of development of SSI (p=0.019). Cesarean with mean operative time >45 min had statistically significant risk of developing SSI. Intraoperative complication like adhesions was a predictor of SSI (p=0.001)
Conclusions: Medical morbidities and increased body mass index being predictors along with prolonged operative time can be properly identified and awareness ensured to prevent and identify post cesarean SSI.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control 1999;27:97-132; quiz 133-4; discussion 96. PMID 10196487
El-Achi V, Wan KM, Brown J, Marshall D, McGee T. Readmissions for surgical site infections following caesarean section. Aust N Z J Obstet Gynaecol 2018;58:582-5. doi: 10.1111/ajo.12796, PMID 29504126
Novelia S, Sae Sia WS, Songwathana P. Surgical site infection among women postcesarean section: An integrative review. Nurs Med J Nurs 2017;7:46-55. doi: 10.14710/nmjn.v7i1.15127
Tran TS, Jamulitrat S, Chongsuvivatwong V, Geater A. Risk factors for postcesarean surgical site infection. Obstet Gynecol 2000;95:367-71. doi: 10.1016/s0029-7844(99)00540-2, PMID 10711546
Wodajo S, Belayneh M, Gebremedhin S. Magnitude and factors associated with post-cesarean surgical site infection at Hawassa University teaching and referral hospital, Southern Ethiopia: A cross-sectional study. Ethiop J Health Sci 2017;27:283-90. doi: 10.4314/ejhs. v27i3.10, PMID 29217927, PMCID PMC5614999
Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control 2014;3:25. doi: 10.1186/2047-2994-3-25, PMID 25126415
Kondakasseril NR, Hiran N, Andrews AM. Surgical site infection following lower segment caesarean section in a tertiary care hospital. J Evol Med Dent Sci 2016;5:1306-9. doi: 10.14260/jemds/2016/305
Vijayan CP, Simi M, Nath AG. Surgical site infection following Caesarean section in a teaching hospital. Int J Sci Stud 2016;3:97-101.
De D, Saxena S, Mehta G, ReenaYadav R, Dutta R. Risk factor analysis and microbial etiology of surgical site infections following lower segment caesarean. Int J Antibiot 2013;2013:283025. doi: 10.1155/2013/28302.
Zuarez-Easton S, Zafran N, Garmi G, Salim R. Postcaesarean wound infection: Prevalence, impact, prevention, and management challenges. Int J Womens Health 2017;17:8188.
Devi SL, Durga DV. Surgical site infections post cesarean section. Int J Reprod Contracept Obstet Gynecol 2018;7:2486-9.
Thakur N, Kujur A. Microbiological and antibiotic sensitivity pattern of surgical site infection following caesarean section in a tertiary care center of Chhattisgarh. Int J Reprod Contracept Obstet Gynecol 2021;10:2638-46. doi: 10.18203/2320-1770.ijrcog20212369
Rabiu KA, Akinlusi FM, Adewunmi AA, Taiwo GA, Durojaiye IA. Risk factors for postcaesarean wound infection in a tertiary hospital in Lagos, Nigeria. Niger Med J 2020;61:262-8.
Krieger Y, Walfisch A, Sheiner E. Surgical site infection following caesarean deliveries: Trends and risk factors. J Matern Fetal Neonatal Med 2017;30:8-12. doi: 10.3109/14767058.2016.1163540, PMID 27023698
Kawakita T, Landy HJ. Surgical site infections after Caesarean delivery: Epidemiology, prevention and treatment. Matern Health Neonatol Perinatol 2017;3:12.
Shree R, Park SY, Beigi RH, Dunn SL, Krans EE. Surgical site infection following caesarean delivery: Patient, provider, and procedure-specific risk factors. Am J Perinatol 2016;33:157-64. doi: 10.1055/s-0035- 1563548, PMID 26344010
Abdallah A, Rafeek ME. Risk factors of surgical site infection of Caesarean section and role of skin cleansing and prophylactic antibiotic. Int J Reprod Gynecol 2018;4:47-51.
Shukkur SA, Rao SM, Zubair SM. Prospective Analysis of Wound Infection following Cesarean Section. United States: Research Square; 2020.
Schneid-Kofman N, Sheiner E, Levy A, Holcberg G. Risk factors for wound infection following caesarean deliveries. Int J Gynaecol Obstet 2005;90:10-5. doi: 10.1016/j.ijgo.2005.03.020, PMID 15913620
Samuel W, Shrestha S, Shrestha R, Shrestha B, Dongol A. Incidence and risk factors of surgical site infection following cesarean section at Dhulikhel Hospital. Kathmandu Univ Med J 2014;12:113-6. doi: 10.4314/ejhs.v27i3.10
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