1887
Volume 2012, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

The incidence of post caesarean wound infection and independent risk factors associated with wound infection were retrospectively studied at a tertiary care hospital.

A retrospective case controlled study of 107 patients with wound infection after lower segment caesarean section (LSCS) was undertaken between January 1998 and December 2007. The control group comprised of 340 patients selected randomly from among those who had LSCS during the study period with no wound infection. Chart reviews of patients with wound infection were identified using the definitions from the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance Systems. Comparisons for categorical variables were performed using the 2 or Fisher exact test. Continuous variables were compared using the 2-tailed Student test. P < 0.05 was considered significant. Logistic regression determined the independent risk factors.

The overall wound infection rate in the study was 4.2% among 2 541 lower transverse CS. The independent risk factors identified for wound infection were, obesity, duration of labor >12 hours, and no antenatal care. Patients' age and parity, diabetes mellitus, premature rupture of membranes (PROM) >8 hours and elective vs. emergency surgery was not found to be significantly associated with wound infection. The independent risk factors could be incorporated into the policies for surveillance and prevention of wound infection. Antibiotic prophylaxis may be utilized in high risk patients such as PROM, obese patients and prolonged labor.

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References

  1. Chain W, Bashiri A, Bar-David J, Sheham-Yardi I, Mezor M. Prevalence and clinical significance of postpartum endometritis and wound infection. Infect Dis Obstet Gynecol. 2000; 8::7782.
    [Google Scholar]
  2. Tran TS, Jamuditrat S, Chongsuvivatwong V, Geater A. Risk factors for postcesarean surgical site infection. Obstet Gynecol. 2000; 95::367371.
    [Google Scholar]
  3. Killian CA, Graffunder EM, Vinciguerra TJ, Venezia RA. Risk factors for surgical- site infections following cesarean infection. Infect Control Hosp Epidemiol. 2001; 22::613617.
    [Google Scholar]
  4. Yokoe DS, Noskin GA, Cunnigham SM, Zuccotti G, Plaskett T, Fraser VJ, Olsen MA, Tokars JI, Solomon S, Perl TM, Cosgrove SE, Tilson RS, Greenbaum M, Hooper DC, Sands KE, Tully J, Herwaldt La, Diekema DJ, Wong ES, Climo M, Platt R. Enhanced identification of postoperative infections among inpatients. Emerg Infect Dis. 2004; 10:11:19241930.
    [Google Scholar]
  5. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004; 32::470485.
    [Google Scholar]
  6. Opoien HK, Valba A, Grinde-Anderson A, Walberg M. Post-cesarean section surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study. Acta Obstet Gynecol Scand. 2007; 86:9:10971102.
    [Google Scholar]
  7. Morhason-Bello IO, Oladokun A, Adedokun BO, Obisesan KA, Ojengbede OA, Okuyemi OO, Niger J. Determinants of post-caesarean wound infection at the University College Hospital Ibadan, Nigeria. Niger J Clin Pract. 2009; 2:1:15.
    [Google Scholar]
  8. Koigi-Kamau R, Kabare LW, Wanyoke-Gichuhi J. Incidence of wound infection after caesarean delivery in a district hospital in central Kenya. East Afr Med J. 2005; 82:7:357361.
    [Google Scholar]
  9. Beattie PG, Rings TR, Hunter MF, Lake Y. Risk factors for wound infection following caesarean section. Aust N Z J Obstet Gynaecol. 1994; 34:4:398402.
    [Google Scholar]
  10. Schneid-Kofman N, Sheiner E, Levy A, Holcberg G. Risk factors for wound infection following cesarean deliveries. Int J Gynaecol Obstet. 2005; 90::1015.
    [Google Scholar]
  11. Habib F. Incidence of post cesarean section wound infection in a tertiary hospital, Riyadh, Saudi Arabia. Saudi Med J. 2002; 23:9:10591063.
    [Google Scholar]
  12. 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. 2006; 29:6:447484.
    [Google Scholar]
  13. Johnson A, Young D, Reilly J. Caesarean section surgical site infection surveillance. J Hosp Infect. 2006; 64::3035.
    [Google Scholar]
  14. Zerr KJ, Furnary AF, Grunkemeier Gl, Bookin S, Kanhere V, Starr A. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997; 63::356361.
    [Google Scholar]
  15. Thigpen BD, Hood WA, Chauhan S, Bufkin L, Bofill J, Magann E, Morrison JC. Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial. Am J Obstet Gynecol. 2005; 192::18641868; discussion 1868–1871.
    [Google Scholar]
  16. Sullivan SA, Smith T, Chang E, Hulsey T, Vandorsten JP, Soper D. Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing post-cesarean infectious morbidity: a randomized, controlled trial [published erratum appears in Am J Obstet Gynecol 2007; 197:333]. Am J Obstet Gynecol. 2007; 196::455.e1455.e5.
    [Google Scholar]
  17. Smaill FM, Gyte GM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev. 2010; 1:CD007482. DOI: 10.1002/14651858. CD007482. pub 2.
    [Google Scholar]
  18. Krentner A, Del Bene V, Delamar D, Huguley V, Harnon P, Mitchell K. Peri-operative antibiotics prophylaxis in caesarean section. Obstet Gyecol. 1978; 52::279284.
    [Google Scholar]
  19. Committee ACOG. Opinion – practice bulletin number 465. Antimicrobial prophylaxis for cesarean delivery. Obstet Gynecol. 2010; 116:3:791792.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): caesarean sectionpost caesarean infectionrisk factors and wound infection
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