Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section

Background.Independent risk factors for surgical site infection (SSI) after cesarean section have not been well documented, despite the large number of cesarean sections performed and the relatively common occurrence of SSI.Objective.To determine independent risk factors for SSI after low transverse cesarean section.Design.Retrospective case-control study.Setting.Barnes-Jewish Hospital, a 1,250-bed tertiary care hospital.Patients.A total of 1,605 women who underwent low transverse cesarean section during the period from July 1999 to June 2001.Methods.Using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for SSI or wound complication and/or data on antibiotic use during the surgical hospitalization or at readmission to the hospital or emergency department, we identified potential cases of SSI in a cohort of patients who underwent a low transverse cesarean section. Cases of SSI were verified by chart review using the definitions from the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System. Control patients without SSI or endomyometritis were randomly selected from the population of patients who underwent cesarean section. Independent risk factors for SSI were determined by logistic regression.Results.SSIs were identified in 81 (5.0%) of 1,605 women who underwent low transverse cesarean section. Independent risk factors for SSI included development of subcutaneous hematoma after the procedure (adjusted odds ratio [aOR], 11.6 [95% confidence interval {CI}, 4.1–33.2]), operation performed by the university teaching service (aOR, 2.7 [95% CI, 1.4–5.2]), and a higher body mass index at admission (aOR, 1.1 [95% CI, 1.0–1.1]). Cephalosporin therapy before or after the operation was associated with a significantly lower risk of SSI (aOR, 0.2 [95% CI, 0.1–0.5]). Use of staples for skin closure was associated with a marginally increased risk of SSI.Conclusions.These independent risk factors should be incorporated into approaches for the prevention and surveillance of SSI after surgery.

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Incidence of Surgical Site Infection among Post C Section Women Presented in Surgical Emergency of tertiary care hospital

10.53350/pjmhs211581836 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1836-1837

Author(s):

S Aliza Z Bokhari ◽

M. Irfan Fazal ◽

Maha Naseem ◽

M. Adnan Mumtaz ◽

S. Mahum Z Bokhari ◽

...

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Surgical Site Infection ◽

Tertiary Care ◽

Care Hospital ◽

Site Infection ◽

Surgical Emergency ◽

Key Factor ◽

Questionnaire Form ◽

Aseptic Conditions

Aim: To rule out incidence and risk factors that are associated with infection at site of surgery after cesarean section. Method: A type of retrospective study was conducted on 100 women who underwent cesarean delivery procedures within a period of 8 month from September 2020 to April 2021 and presented in surgical emergency at Mayo Hospital Lahore. The socioeconomic, demographic and clinical parameters of patients were collected by a questionnaire form. A program known as SPSS version 20 was used for analysis of data that is collected in study. Result: After analyzing the data following factors are identified that causes surgical site infection: Higher BMI (more than 30kg/m2), loss of blood during cesarean section(more than 500mL), poor hygienic care after cesarean section, poor socioeconomic status leads to malnutrition of patient and that leads to poor wound healing and surgical site infection. Lack of education is also a key factor in SSIs. Cesarean done in emergency under improper aseptic conditions also promote SSIs. All these factors are associated with incidence of SSI. Conclusion: SSIS are conventional among women presented in surgical emergency of Mayo Hospital Lahore within 30 days of cesarean section. Management of risk factors causing SSIs in women after cesarean section may decrease the incidence of such infections. Keywords: Cesarean section, risk factors, infection at surgery site.

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Incidence and risk factors for maternal surgical site infection after cesarean section.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.10.6187 ◽

2021 ◽

Vol 28 (10) ◽

pp. 1495-1500

Author(s):

Sadia Zaineb ◽

Amina Akbar ◽

Mobeen Ikram ◽

Saira Mahboob ◽

Arshad Mahmood ◽

...

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Surgical Site Infection ◽

Wound Infection ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Site Infection ◽

Cross Sectional ◽

Antenatal Visits

Objective: To ascertain the frequency and risk factors for post-operative surgical site infection (SSI) in cesarean section. Study Design: Cross-sectional study. Setting: Departments of Gynecology & Obstetrics and Anesthesiology, Secondary Care Hospital. Period: January to December 2017. Material & Methods: After the approval of hospital ethical committee, 337 parturient who underwent cesarean section were included in our study. Outcomes were: frequency and risk factors for post-cesarean wound infection. Data was analyzed by SPSS version 20. Qualitative data presented as frequency and percentage. Chi-square (Fishers test) used to analyze significance. P-value ≤ 0.05 taken as significant. Results: A total of 337 patients were included in our final analysis. The frequency of wound infection was 15 (4.4%). The mean age was 27.5 years ± 5.8 in our study population. There was no difference in age (p=0.781), parity (p=0.898), antenatal visits (p=0.319), referral from doctor (p=0.205), anemia (p=0.731), nature of surgery (elective or emergency LSCS) p=0.548, severity of anemia (p=0.962), blood grouping Rh-factor (p=0.531), chorioamnionitis (p=0.707), labor (p=0.955), premature rupture of membrane (p=0.427) and antepartum hemorrhage (p=0.769). 11 (3.3%) of the patients with SSI were treated conservatively while 4 (1.2%) required debridement and secondary suturing. None of our patients required referral to tertiary care hospital for treatment of SSI. Conclusion: The incidence of SSI after cesarean section was less in our study and we didn’t find maternal age, gestational age, previous cesareans delivery, antenatal visits, PROM, labor before LSCS, anemia to be associated with risk of SSI.

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Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Journal of Anesthesia ◽

10.1007/s00540-016-2266-2 ◽

2016 ◽

Vol 31 (1) ◽

pp. 120-126 ◽

Cited By ~ 6

Author(s):

Manuel C. Vallejo ◽

Ahmed F. Attaallah ◽

Robert E. Shapiro ◽

Osama M. Elzamzamy ◽

Michael G. Mueller ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Cesarean Delivery ◽

Medical Center ◽

Tertiary Care ◽

Site Infection ◽

Tertiary Care Medical Center ◽

Independent Risk Factors

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EMERGENCY LAPAROTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.06.1215 ◽

2017 ◽

Vol 24 (06) ◽

pp. 808-811

Author(s):

Ch. Muhammad Atif Niaz ◽

Awais Talib ◽

Yasir Sultan ◽

Asim Shahzad Niazi

Keyword(s):

Surgical Site Infection ◽

Tertiary Care ◽

Primary Data ◽

Emergency Laparotomy ◽

Care Hospital ◽

Site Infection ◽

Increased Risk ◽

Deep Surgical Site Infection ◽

Male Patients ◽

Hospital Study

Objectives: Emergency laparotomy followed by placement of drain is acommon procedure in tertiary care hospitals but there are contradictory evidences regardingits association with deep surgical site infection. Thus current study was planned with anobjective to compare the frequency of deep surgical site infection among patients with andwithout postoperative drains after undergoing an emergency laparotomy at a tertiary carehospital. Data source: Primary data based on patients undergoing emergency laparotomy attertiary care hospital. Study design: Randomized control trial. Setting: Department of surgicalunit-III, Jinnah Hospital Lahore. Duration of study: Study was conducted from January 2016to December 2016. Subjects & methods: About 400 patients of 15-70 years undergoingemergency laparotomy were selected using non-probability consecutive sampling techniqueafter informed consent. Information regarding their demographic characteristics and studyvariable was recorded in a structured proforma. All the subjects were randomized into twogroups i.e. with and without post-operative drains using table of random number. Frequencyof deep surgical site infection was assessed on 7th post operative day and data was analyzedusing SPSS version 21.0. Result: The mean age of patients was 38.92 ± 6.246 years withabout 229(57.2%) male patients. The frequency of development of deep surgical site infectionin first postoperative week was 51(12.7%) overall, with 24(12%) patients in the group of postoperativedrains and 27(13.5%) patients without post-operative drains. The differences betweentwo groups were statistically insignificant. Moreover, it was not significantly related to the age,gender, duration of stay in the hospital and smoking. Conclusion: It can be concluded from thestudy that there is no significantly increased risk of deep surgical site wound infection with orwithout placement of drain. So it is reasonable and safe approach to place a drain in the woundfor the early detection of bleeding or leakage to decrease the morbidity and complication in thepatients.

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Incidence and risk factors for post caesarean delivery surgical site infection in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212169 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2316

Author(s):

Smita S. Naik ◽

Ajit Nagarsenkar

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Incidence Rate ◽

Tertiary Care ◽

Prophylactic Antibiotic ◽

Public Health Care ◽

Care Hospital ◽

Site Infection ◽

Medical College ◽

Modifiable Factors

Background: Post-operative surgical site infection (SSI) is the most commonly reported nosocomial infection which constitutes a major public health care problem worldwide. SSI are the one of the most common complication after caesarean section (C-sec) and results in maternal morbidity and mortality, increased length of the hospital stays and economic burden. The aim of the study is to determine the incidence and risk factors of SSI in women undergoing C-sec.Methods: The prospective observational study carried out in department of Obstetrics and Gynaecology in Goa medical college, Bambolim Goa from 1st November 2017 to 30th May 2019. Collection of data was carried using predesigned and pretested proforma. SSI was examined for association of different risk factors and its distribution.Results: During this study period, 2106 patients underwent C-sec, out of which 103 patients developed post-operative SSI with the incidence rate being 4.89%. The incidence rate was found higher in emergency cases (6.55%) as compared to that of elective (1.21%) and median time to SSI was the 6th post- operative day. Majority of SSI, i.e., 102 out of 103 (99.08%) were superficial SSI, 1 (0.98%) were deep SSI and no organ/space SSI. The highest rate of SSI was found in 21-34 years of age group (84.47%). The common risk factors associated are anaemia, diabetes, hypertension and obesity.Conclusions: SSI results from multiple risk factors which include modifiable and non- modifiable factors and thorough analysis of these factors can help prevent SSI. The medical staff should focus on some of the modifiable risk factors can be eliminated by strict antisepsis, timely prophylactic antibiotic and maintaining normothermia as well as optimal glucose level.

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A study of incidence and risk factors of Surgical site infection following orthopedic surgical procedure in a tertiary care hospital in south India

International Journal of Medical Research and Review ◽

10.17511/ijmrr.2015.i9.182 ◽

2015 ◽

Vol 3 (9) ◽

pp. 983-989

Author(s):

Dr Ali Mohammed P ◽

◽

Dr Deep Sharma ◽

Dr D K Patro ◽

DR Jagdish Menon ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Surgical Procedure ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Site Infection

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Risk Factors for Surgical Site Infection Complicating Laminectomy

Infection Control and Hospital Epidemiology ◽

10.1086/519864 ◽

2007 ◽

Vol 28 (9) ◽

pp. 1060-1065 ◽

Cited By ~ 81

Author(s):

N. Deborah Friedman ◽

Daniel J. Sexton ◽

Sarah M. Connelly ◽

Keith S. Kaye

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Risk Index ◽

Tertiary Care ◽

Operating Experience ◽

Care Facility ◽

Site Infection ◽

Surgical Specialty ◽

Tertiary Care Facility ◽

Independent Risk Factors

Objective.To examine risk factors for surgical site infection (SSI) following spinal surgery and to analyze the associations between a surgeon's years of operating experience and surgical specialty and patients' SSI risk.Design.Case-control study.Setting.A tertiary care facility and a community hospital in Durham, North Carolina.Patients.Each case patient who developed an SSI complicating laminectomy was matched with 2 noninfected control patients by hospital, year of surgery, and National Nosocomial Infection Surveillance System risk index score.Results.Forty-one case patients with SSI complicating laminectomy and 82 matched control patients were analyzed. Nonwhite race, diabetes and an elevated body mass index (BMI) were more common among case patients than among control patients. Subjects with a BMI greater than 35 were more likely to undergo a prolonged procedure, compared with case patients who had a BMI of 35 or less. The SSI rate for patients operated on by neurosurgeons was 28%, compared with 43% for patients operated on by orthopedic surgeons (odds ratio [OR], 0.5; P = .12). The number of years of operating experience were not associated with SSI risk. Multivariate analysis revealed diabetes (OR, 4.2 [95% confidence interval {CI}, 1.1-16.3]; P = .04), BMI greater than 35 (OR, 7.1 [95% CI, 1.8-28.3]; P = .005), and laminectomy at a level other than cervical (OR, 6.7 [95% CI, 1.4-33.3]; P = .02) as independent risk factors for SSI following laminectomy.Conclusion.Diabetes, obesity, and laminectomy at a level other than cervical are independent risk factors for SSI following laminectomy. Preoperative weight loss and tight perioperative control of blood glucose levels may reduce the risk of SSI in laminectomy patients.

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Surgical site infections at a Saudi hospital: The need for a national surveillance program

International Surgery ◽

10.9738/intsurg-d-16-00199.1 ◽

2017 ◽

Author(s):

Saeed Ali Alsareii

Keyword(s):

Risk Factors ◽

Developing Countries ◽

Surgical Site Infection ◽

Tertiary Care ◽

Significant Risk ◽

Surveillance Program ◽

Care Hospital ◽

National Surveillance ◽

Site Infection ◽

Acinetobacter Spp

ABSTRACT Background: Surgical site infection (SSI) continues to be a global health problem that causes increased morbidity and mortality, especially in developing countries. Objective: This study aimed to determine the prevalence of SSI, the microbial pathogens and their resistance patterns, as well as to identify risk factors associated with this infection at a Saudi tertiary care hospital. Methods: This cross-sectional observational study involved all patients who had surgery and who stayed in the hospital for at least 48 h during a one-year period. SSI was diagnosed using the guidelines of the Centers for Disease Control and Prevention. Results: A total of 2160 patients were included and the overall SSI rate was 10.2%. Malignancy (OR = 1.63), duration of operation (OR = 1.41), high ASA score (OR = 1.8), and clean-contaminated (OR = 1.5) and contaminated operations (OR = 3.2) were found to be statistically significant risk factors for SSI. The most frequently isolated microorganisms were Acinetobacter spp. (31.5%), E. coli (25.5%) and Pseudomonas spp. (17.9%). Conclusions: This study further illustrates the burden of SSI in a typical hospital situation in developing countries. Our findings highlight the urgent need to develop a consistent national surveillance program for SSI with accurate feedback of appropriate data to help surgeons control and reduce the SSI rates in developing countries. Keywords: Surgical site infection - surveillance - contaminated wounds - Acinetobacter spp.

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