scholarly journals Assessment of risk factors for surgical site infection following caesarean section

2019 ◽  
Vol 8 (11) ◽  
pp. 4518
Author(s):  
Aditi Sangwan ◽  
Vani Malhotra
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Emergency Caesarean ◽  
Group I ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Wound Discharge ◽  
Group Ii

Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus.      Mean duration of resuturing was 17.42±6.98 days.  Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.

scholarly journals Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical College ◽  
Related Risk ◽  
Microbiological Methods ◽  
Duration Of Surgery ◽  
History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

Compare the Incidence of Surgical Site Infection after Appendectomy Wound Irrigation with Normal Saline and Imipenem Solutions

2021 ◽  
Vol 15 (8) ◽  
pp. 2184-2186
Author(s):  
Ahmad Shah ◽  
Nazeer Ahmad Sasoli ◽  
Farrukh Sami
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Saline Solution ◽  
Abscess Formation ◽  
Site Infection ◽  
Wound Irrigation ◽  
Group I ◽  
Perforated Appendix ◽  
The Mean ◽  
Group Ii

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

Risk factors for surgical site infection following caesarean section in England

2013 ◽  
Vol 120 (4) ◽  
pp. 509-510 ◽  
Author(s):  
C Wloch ◽  
J Wilson ◽  
T Lamagni ◽  
P Harrington ◽  
A Charlett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Site Infection

scholarly journals A prospective study of surgical site infection of orthopedic implant surgeries

2017 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Muhammad Thahir ◽  
Suresh Gandhi ◽  
Kalaivanan Kanniyan ◽  
Ravi Kumar
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Risk Index ◽  
Univariate Analysis ◽  
Cost Of Care ◽  
Orthopaedic Implant ◽  
Site Infection ◽  
Duration Of Surgery

<p class="abstract"><strong>Background:</strong> Surgical-site infection accounts for approximately 10% of all hospital-acquired infections, which are estimated to double the cost of care and result in an additional mean of 6.5 days of hospital stay. We did prospective study of surgical site infection of orthopaedic implant surgeries.</p><p class="abstract"><strong>Methods:</strong> The aim of the study is to assess the clinical and microbiological outcome of 125 patients who had open reduction and internal fixation with implants and prosthesis at Southern Railway Hospital from January 2006 to January 2007, and its strength of association with major risk factors using univariate analysis. In our study, Patients were allocated in to three groups as NINS risk index group 0, 1 and 2 with risk factors as duration of surgery &gt;2 hours and ASA class ≥3. Post-operative wound infection was diagnosed based on the criteria of Center of Disease Control and assessed for the period of 6 weeks using National Nosocomial Infections Surveillance Risk Index.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 87 male and 38 females in the study. From 125 Patients, 13 patients had post-operative superficial surgical site infection and presented within 21 days of operation. The infection rate was 10.4%. Two Patients developed deep infection after 6 weeks of study. All the cases with superficial infection were followed at regular intervals, 11 cases resolved with regular dressing and antibiotics but 2 cases continued to discharge sinus up to 3 months.</p><p><strong>Conclusions:</strong> The study showed that the risk of infection rate increased significantly with ASA score, duration of surgery, obesity and NINS risk index. There was no significant association of infection rate with age, diabetes and smoking. </p>

Risk Factors for Surgical Site Infection in Children

2006 ◽  
Vol 27 (7) ◽  
pp. 709-715 ◽  
Author(s):  
Juan Francisco Casanova ◽  
Rafael Herruzo ◽  
Jesús Díez
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Pediatric Patients ◽  
Risk Index ◽  
Venous Catheter ◽  
University Hospital ◽  
Site Infection ◽  
Convenience Sample ◽  
Peripheral Venous Catheter ◽  
Duration Of Surgery

Objectives.To assess the appropriateness of using the indices developed by the Study on the Efficacy of Nosocomial Infection Control (SENIC) and the National Nosocomial Infections Surveillance (NNIS) project to determine risk factors for surgical site infection (SSI) in children and, if not appropriate, to explore the factors related to SSI in children so these factors could be used in a risk index for pediatric patients.Design.Cohort study during more than 4 years.Setting.La Paz University Hospital, a national reference center that serves Health Area 5 of Madrid, Spain, which has approximately 500,000 inhabitants.Patients.Convenience sample consisting of the 3,646 children admitted for surgery who had a postsurgical stay of more than 2 days.Results.A model with 8 predictive factors (degree of surgical contamination; duration of surgery; type of surgery; use of a peripheral venous catheter, central venous catheter, or urinary catheter; number of diagnoses; and SSI exposition time) was created. Its relation to the SSI rate was better than that of the SENIC or NNIS indices. Its sensitivity, specificity, and area under the receiver–operating characteristic curve were higher than that of the SENIC index.Conclusions.The model that we created seems to be more adequate for predicting SSI and evaluating pediatric patients' intrinsic risk than the SENIC and NNIS indices.

scholarly journals Surgical Site Infection in Spine Surgery: Who Is at Risk?

2018 ◽  
Vol 8 (4_suppl) ◽  
pp. 5S-30S ◽  
Author(s):  
Reina Yao ◽  
Hanbing Zhou ◽  
Theodore J. Choma ◽  
Brian K. Kwon ◽  
John Street
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Surgical Site Infection ◽  
Spine Surgery ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Preoperative Radiation ◽  
Site Infection ◽  
Postoperative Blood Transfusion ◽  
Duration Of Surgery

Study Design: Retrospective literature review of spine surgical site infection (SSI). Objective: To perform a review of SSI risk factors and more specifically, categorize them into patient and surgical factors. Methods: A review of published literature on SSI risk factors in adult spine surgery was performed. We included studies that reported risk factors for SSI in adult spinal surgery. Excluded are pediatric patient populations, systematic reviews, and meta-analyses. Overall, we identified 72 cohort studies, 1 controlled-cohort study, 1 matched-cohort study, 1 matched-paired cohort study, 12 case-controlled studies (CCS), 6 case series, and 1 cross-sectional study. Results: Patient-associated risk factors—diabetes mellitus, obesity (body mass index >35 kg/m2), subcutaneous fat thickness, multiple medical comorbidities, current smoker, and malnutrition were associated with SSI. Surgical associated factors—preoperative radiation/postoperative blood transfusion, combined anterior/posterior approach, surgical invasiveness, or levels of instrumentation were associated with increased SSI. There is mixed evidence of age, duration of surgery, surgical team, intraoperative blood loss, dural tear, and urinary tract infection/urinary catheter in association with SSI. Conclusion: SSIs are associated with many risk factors that can be patient or surgically related. Our review was able to identify important modifiable and nonmodifiable risk factors that can be essential in surgical planning and discussion with patients.

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

2017 ◽  
Vol 13 (3) ◽  
pp. 314-317
Author(s):  
Manisha Chhetry ◽  
Shanti Subedi ◽  
Basudeb Banerjee
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Emergency Procedures ◽  
Membrane Rupture ◽  
Duration Of Surgery ◽  
Elective Cesarean ◽  
Associated Risk Factors

Background & Objectives:Post cesarean surgical site infection (SSI) is one of the commonly encountered complications which considerably increase the burden to health care. It is caused due to the interplay of various patient related, procedure related and iatrogenic factors. This study aims at identifying common risk factors for post cesarean SSI at our centre.Materials & Methods:This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included and their risk factors were studied.Results:Emergency procedures (82.97%) were more likely to develop SSI as compared to elective cesarean (17%). Among the patient related risk factors most of them were nulliparous (48.9%), term gestation (42.6%), malnourished (53.1%) and had history of prolonged leaking (44.68%) The mean age was 24.04±4.6years.Most of the patients who developed SSI were operated for repeat cesarean and fetal indications. Most patients who had SSI had at three to five per vaginal examinations (2.72±2). 66% of patient who had SSI had duration of surgery more than one hour. 68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultantsConclusion:The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon. 

scholarly journals Study on Risk Factors and Microorganisms for Surgical Site Infection following Caesarean Section among 100 Patients in a Tertiary Hospital in Bangladesh

2019 ◽  
Vol 9 (2) ◽  
pp. 90-96
Author(s):  
Sayma Afroz ◽  
Maliha Rashid
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Mode Of Delivery ◽  
Operation Time ◽  
Site Infection ◽  
College Hospital ◽  
Bacteriological Study ◽  
E Coli

Background: Lower uterine caesarean section is a common mode of delivery now and surgical site infection is one of the most common and dreaded complication of surgery. It is associated with significant morbidity and delayed recovery and it lengthens hospital stay and costs. Identifying risk factors for surgical site infection in caesarean wound and modifying them can be beneficial for patient management during surgery and optimizing good clinical outcome. Identifying microorganisms with their sensitivity has epidemiological as well as therapeutic implications. Objective: To identify risk factors for surgical site infection in caesarean section wound and find out microorganisms responsible for such infection. Materials and Methods: In this study 100 women with surgical site infection after caesarean section were included. They were selected randomly from four maternity units of Dhaka Medical College Hospital. Each patient of caesarean section was followed strictly up to discharge from hospital and also for 30 days postoperatively for any evidence of infection. Wound swab was sent in each case for microbiological study. Data were collected in structured questionnaire and analysed by computer using spreadsheet. Results: Among 100 women studied, 73% had inadequate or no antenatal check-up, 52% had duration of labour pain >12 hours, 52% had duration of ruptured membrane >12 hours, 94% women underwent emergency caesarean section, 62% had operation time >1 hour, 61% had haemoglobin level <60%, 46% women had intervention by untrained birth attendant, and 43% women had >500 mL blood loss during operation. In bacteriological study, microorganisms were identified in 55% cases, among them Staphylococcus aureus (20%), E. coli (11%), Acinetobacter (7%), Pseudomonas (6%) and Proteus (5%). During sensitivity test Staphylococcus aureus was mostly sensitive to ceftriaxone (50%) and amikacin (33%) and E. coli to amikacin (80%). In four cases (2 proteus and 2 pseudomonas) out of 55 organisms were resistant to all antibiotics. Conclusion: Most of the risk factors for surgical site infection during caesarean section identified in this study can be modified through intervention. However, the microorganisms detected from our patients showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Enam Med Col 2019; 9(2): 90-96

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