A study of post-cesarean surgical site infections in a tertiary care unit

Introduction: Surgical site infection in cesarean deliveries is a major cause of morbidity and mortality, increasing both in duration of patient hospitalization and hospital costs. There has been an alarming increase in the incidence of SSI in both developing and developed countries accounting for 20-25% of the nosocomial infections worldwide. Multiple risk factors causing post-cesarean SSI have been documented. Despite most modern facilities and standard protocols of preoperative preparation and antibiotic prophylaxis, surgical site infections remain a major cause of hospital-acquired infections. Material and methods: This is a prospective observational study performed from January 2015 to June 2017 with 1304 patients as the study population. All these patients were thoroughly examined and investigated. Wound was checked on day 5 of LSCS and in patients with SSI, wound swab was sent for culture sensitivity. Risk factors contributing to the SSI were noted. The wound was graded according to Southampton's grading system and further treatment was done in accordance to the grade of wound and the culture sensitivity report. Results:  1304 were LSCS patients who were eligible for analysis, of which 43 patients developed surgical site infection which was 3.29% wound infection rate, of which 69% were emergency and 31% were elective. These patients were evaluated for risk factors and prolonged leaking per vaginum was the most common one. The wounds were graded according to Southampton's wound grading system and most wounds were found to be 3a subtype while E. coli was the organism most commonly detected amongst the 18 patients with a culture positive report.