Observational study of post operative wound infections risk factors
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 1036-1049
AbstractTo survey and critically analyse the number and cause of surgical site infections post cesarean sections in my hospital for a period of 1 year and to provide data to aid in formulating recommendations to reduce their incidence. To assess the incidence of SSIs after cesarean sections and to explore causative and risk factors. To identify the common causative pathogens and their antibiotic sensitivity profile.
Methods: The study was a cross sectional observational study conducted in a tertiary care teaching hospital between July 2020 and June 2021 with sample size of 305 post operative patients after a cesarean section. Nature of wound complication and the postoperative day of occurrence of complication was noted. Baseline and special investigations like wound swab for culture and sensitivity were sent. The patients were followed through daily dressing and wound fortification techniques used were noted. The duration of hospital stays, and status of repaired wound were noted.
Results: The incidence of wound infection in our present study was 10.1%. The present study shows that Obesity, Anemia, Diabetes, HTN are associated with higher incidence of wound infections. The present study shows that PROM is associated with increased number of wound infections. The use of non-absorbable sutures like nylon and prolene instead of absorbable sutures like vicryl didn’t reduce the incidence of wound infections. Most of the wound infections occurred on 4th and 5th postoperative day. Most cases of wound infections occurred in cases operated for previous LSCS. Secondary suturing along with higher antibiotics proved to be effective in treating wound infections. 99% of cases with wound infections after treatment had well healed wounds.
Conclusions: The most common organism isolated was Pseudomonas followed by Klebsiella. The organisms are most sensitive to Piperacillin and tazobactam followed by Amoxyclav. Strategies for prevention of SSI must aim to correct anemia prior to delivery, avoid prolonged hospital stay prior to delivery, to correct maternal comorbidities prior to surgery and strict adoption of asepsis. Higher antibiotics should be started preoperatively for PROM cases. SSI surveillance must be done as a part of healthcare associated infections audit which aims at improving quality control measures and infection control practices
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