Postoperative wound infection after obstetrics and gynaecology surgeries: A study from the tribal tertiary healthcare centre
Abstract
Aims and Objectives: the study was conducted to find out the incidence of postoperative wound infection among obstetric and gynaecological surgeries in the tribal area of Rajasthan region with the objective to identify various preventable risk factors and common responsible pathogen.
Material and methods: It was a prospective study conducted in the department of Gynaecology in Government Medical College and Hospital, Dungarpur during the period of six months from August 2019 to January 2020.
Results: Out of 300 surgeries performed, 210 surgeries were obstetrics and 90 surgeries were gynaecological. The mean age of obstetrics cases was 26.89±2.5 years and of gynaecological cases was 48.22±4.8 years. Frequency of wound infection in obstetrics cases was 5.23% (11 cases) and was 11.11% (10 cases) in gynaecological surgeries with a total frequency of 7% (21 cases). Mean postoperative day of wound infection was 9.81±5.6, mean postoperative hospital stay was 8.10±5.6 days and the mean duration of surgery was 1.29±0.45 hours. Body mass index (BMI) was >25 (obese) in 61.90% of infected cases. 15 patients (10.41%) out of 144 patients who did not receive antibiotic prophylaxis, developed wound infection. On culture, Escherichia Coli (E.coli) was found to be the most common responsible pathogen (38.09%) followed by Klebsiella species and Staphylococcus aureus (19.04%).
Conclusion: Early identification of various risk factors for postoperative wound infection in obstetric and gynaecological surgeries is essential to prevent further morbidities.
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References
Amenu D, Belachew T, Araya F. Surgical site infection rate and risk factors among obstetric cases of Jimma University specialized hospital, southwest ethiopia. Ethiop J Health Sci 2011; 21: 91-100.
Cruse PJ, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27-40.
Rock JA, Jones HW. Te Linde’s Operative Gynecology. 10th ed2008.
De la Fuente Fonnest I, Stigsby B, Heisterberg L. Risk factors in wound infections after laparotomy in obstetrics and gynaecology. Dan Med Bull 1999; 46: 254-7.
Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk factors for surgical site infection after low transverse cesarean section. Infect Control Hosp Epidemiol 2008; 29(6): 477-84; discussion 85-6.
Mishriki SF, Law DJ, Jeffery PJ. Factors affecting the incidence of postoperative wound infection. J Hosp Infect. 1990 Oct; 16(3):223-30.
Rahman Jahanara, Sultana Nasreen, Hasan Munir, Begum Hosne Ara, Factors of post-operative wound infections in abdominal surgeries of Obstetrics and Gynaecology, Dept; Journal of Dhaka Medical College Hos. 2011;18(01):39-42.
Bhadauria AR, Hariharan C. Clinical study of post operative wound infections in obstetrics and gynaecological surgeries in a tertiary care set up. Int J Reprod Contracept Obstet Gynecol 2013;2:631-8.
A Nuwal, VR shriwastava, A Giri. A prospective study of wound infections after laparotomy in obstetrics and gynaecology department. Nep Med Coll J 2012; 14(4): 267-70.
Tran TS, Jamulitrat S, Chongsuvivatwong V, Geater A. Risk factors for postcesarean surgical site infection. Obstet Gynecol 2000; 95: 367-71.
Suonio S, Saarikoski S, Vohlonen I, Kauhanen O. Risk factors for fever, endometritis and wound infection after abdominal delivery. Int’l J Gynaecol Obstet 1989; 29: 135-42.
Arabshahi KS, Koohpayezade J. Investigation of risk factors for surgical wound infection among teaching hospitals in Tehran. Int’l Wound J 2006; 3: 59-62.
De la Fuente Fonnest I, Stigsby B, Heisterberg L. Risk factors in wound infections after laparotomy in obstetrics and gynaecology. Dan Med Bull 1999; 46: 254-7.
Ezechi OC, Edet A, Akinlade H, Gab-Okafor CV, Herbertson E. Incidence and risk factors for caesarean wound infection in Lagos Nigeria. BMC Res Notes 2009; 2: 186.
Kamat AA, Brancazio L, Gibson M. Wound infection in gynecologic surgery. Infect Dis Obstet Gynecol 2000; 8: 230-4.
Beattie PG, Rings TR, Hunter MF, Lake Y. Risk factors for wound infection following caesarean section. Aust N Z J Obstet Gynaecol 1994; 34: 398-402.
Witt A, Doner M, Petricevic L et al. Antibiotic prophylaxis before surgery vs after cord clamping in elective cesarean delivery: a double-blind, prospective, randomized, placebo controlled trial. Arch Surg 2011; 146: 1404-9.
De Araujo Madeira MZ, Trabasso P. Surgical site infections in women and their association with clinical conditions. Rev Soc Bras Med Trop. 2014 Jul; 47(4):457–61. https://doi.org/10.1590/0037-8682-0125-2014.
Bangal VB, Borawake SK, Shinde KK, Gavhane SP, Bangal Professor VB. Study of surgical site infections following gy¬naecological surgery at tertiary care teaching hospital in ru¬ral India. Int J Biomed Res. 2014. ISSN:976–9633.
De Nardo P, Gentilotti E, Nguhuni B, Vairo F, Chaula Z, Nicastri E, et al. Post-caesarean section surgical site infec¬tions at a Tanzanian tertiary hospital: A prospective ob¬servational study. J Hosp Infect. Elsevier Ltd. 2015 Aug; 93(4):1–5.
Johnson ET. Nosocomial infection: Update. J Natl Med As¬soc. National Medical Association. 1983 Feb; 75(2):147–54.
Ming DY, Chen LF, Miller BA, Sexton DJ, Anderson DJ. The impact of depth of infection and postdischarge sur¬veillance on rate of surgical-site infections in a network of community hospitals. Infect Control Hosp Epidemiol. 2015 Jan; 33(03):276–82. https://doi.org/10.1086/664053 PMid:22314065 PMCid:PMC3629722
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