Postcaeserean Surgical Site Infection at a Tertiary Care Centre in Southern Rajasthan, India

Abstract

Introduction: Surgical Site Infection (SSI) is one of the most common complications of postcaeserean section, which is mainly associated with increase morbidity and mortality. This is also an important cause of prolonged hospital stay, patient dissatisfaction and higher treatment cost. There is very limited data available on the incidence, outcome and clinical spectrum of postcaeserean SSI from Southern Rajasthan. Aim: The aim was to find out the frequency of SSI and variables contributing to it in women who have a caesarean section in a tertiary care centre in Rajasthan, India. Materials and Methods: This was a prospective observational study conducted over a duration of six months from June 2019 to November 2019 at SHKBM, Jhalawar Hospital and Medical College, Jhalawar, Rajasthan, India. All the women who developed postcaeserean SSI during hospital stay or within 30 days following surgery were included in the study. Demographic data and all the potential risk factors were noted. Pus samples from the infected wound were sent for culture and sensitivity. Data was presented as frequencies and percentages. Statistical Package for Social Sciences software (SPSS) version 26.0 and Epi Info Software were used for the statistical analysis. Results: A total of 1157 cases underwent caeserean section during study period, among them 53 cases had postcaeserean SSI, which gives an incidence rate of 4.5%. In present study, majority of women belonged to 21-25 years of age group 33 (62.26%), 31 (58.49%) cases were unbooked, 47 (88.67%) of SSI was seen in emergency caeserean section, and 48 (90.56%) of SSI cases had pfannenstiel incision. Anaemia (81.13%), hypertensive disorder (13.2%) and urinary tract infection (3.77%) were associated medical risk factors for SSI. There were other obstetrics and intraoperative risk factors found to be associated with postcaeserean SSI, out of them previous caesarean section was most common (56.6%). Klebsiella was the most common organism isolated. Conclusion: Infrequent antenatal visits, emergency caeserean sections, anaemia and history of previous caeserean section are the most common risk factors for SSI.