Study of infective morbidity following gynecological surgeries
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20182343Keywords:
Gynaecological surgery, Infective morbidity, Surgical site infectionsAbstract
Background: Post-operative wound infection is a common nosocomial infection all over the world. It is responsible for increase in physical and psychological stress to the patient. It also increases the cost of treatment due to prolonged hospitalization. Present study was carried to find out the post-operative wound infection, morbidity and the risk factors.
Methods: Prospective cross sectional study was carried out at tertiary care teaching hospital for a period of six months. Consecutive 57 cases of surgical site infections (SSI) following obstetric and gynecological abdominal surgery were analyzed.
Results: It was observed that the incidence of SSI was 2.8 percent. Overweight, previous laparotomy scars, emergency surgery and prolong labour were the common risk factors associated with the development of SSI. Certain epidemiological and environmental factors like under nutrition, rural area residence, poverty, illiteracy, ignorance, poor general hygiene, Surgical site infections(SSI) were more commonly observed following emergency operations; laparotomies performed for large ovarian tumours, malignancies and ruptured ectopic pregnancies. Caesarean sections performed for prolong labour, prolong premature rupture membranes, prolonged second stage had more likelihood of development of sepsis. Occurrence of SSI resulted in significant prolongation of hospital stay.
Conclusions: The incidence of SSI in the present study was within acceptable limits. Regular surveillance for SSI in the hospital and sensitization of staff regarding consequences of SSI would go a long way in further reduction in the rate of SSI.
Metrics
References
Cruse PJE, Ford R. The epidemiology of wound infection. A 10 year prospective study of 62,939 wounds. Surg Clin North Am. 1980;60:27–40.
Horan TC, Culver DH, Gaynes RP, Jarvis WR, Edwards JR, Reid CR.. Nosocomial infections in surgical patients in the United States, 1986–1992 (NNIS). Infect Control Hosp Epidemiol. 1993;14:73–80.
Hajjar J, Bavey A, Pinzaru G, Coiron M, Fabry J. Réseau ISO Sud-Est: un an de surveillance des infections du site opératoire. Bulletin Èpidémiologique Hebdomadaire. 1996;42.
Brachman PS, Dan BB, Haley RW, Hooton TM, Garner JS, Allen JR. Nosocomial surgical infections: incidence and cost. Surg Clin North Am. 1980;60:15–25.
Fabry J, Meynet R, Joron MT, Sepetjan M, Lambert DC, Guillet R. Cost of nosocomial infections: analysis of 512 digestive surgery patients. World J Surg. 1982;6:362–5.
Prabhakar P, Raje D, Castle D, Rao B, Fletcher P, Duquesnay D, et al. Nosocomial surgical infections: incidence and cost in a developing country. Am JInfect Control. 1983;11:51–6.
Kirkland KB. The impact of surgical-site infections in the 1990’s: attributable mortality, excess length of hospitalization and extra costs. InfectControl HospEpidemiol, 1999; 20:725–730.
Mayon-White RT, Ducel G, Kereselidze T, Tikomirov E. An international survey of the prevalence of hospital-acquired infection. J Hosp Infect. 1988;11(Supplement A):43–8.
Ponce-de-Leon S. The needs of developing countries and the resources required. J Hosp Infect. 1991;18 (Supplement):376–81.
Plowman R. The socio-economic burden of hospital-acquired infection. Euro Surveill. 2000;5(4):49-50.
Wenzel RP. The economics of nosocomial infections. J Hosp Infect. 1995;31:79–87.
Pittet D, Taraara D, Wenzel RP. Nosocomial bloodstream infections in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1994;271:1598–601.
Wakefield DS, Helms CM, Massanari RM, Mori M, Pfaller M. Cost of nosocomial infection: relative contributions of laboratory, antibiotic, and per diem cost in serious Staphylococcus aureus infections. Amer J Infect Control. 1988;16:185–92.
Coello R, Glenister H, Fereres J, Bartlett C, Leigh D, Sedgwick J, et al. The cost of infection in surgical patients: a case study. J Hosp Infect. 1993;25:239–50.
Chia JY, Tan KW, Tay L. A survey of post-operative wound infections in obstetrics and gynaecology: the Kandang Kerbau Hospital experience. Singapore Med J. 1993;34:221-4.
Mowat J, Bonnar J. Abdominal wound dehiscence after caesarean section. British Med J. 1971;2:256-7.
Pandit A, Sharma P, Yangzom K. Incidence of caesarean wound infection in patan hospital, Nepal J Nepal med assoc. 2003;42:280-3.
Mitt P, Lang K, Peri A, Maimets M. Surgical-site infections following cesarean section in an Estonian university hospital: postdischarge surveillance and analysis of risk factors. Infect Control Hosp Epidemiol. 2005;26(5):449-54.
Amenu D, Belachew T, Araya F. Surgical site infection rate and risk factors among obstetric cases of jimma university specialized hospital, southwest Ethiopia. Ethiop J Health Sci. 2011;21(2):91-100.
Spiliotis J. Wound dehiscence: is still a problem in the 21th century: a retrospective study. World J Emergency Surg. 2009;4:12.
Waqar. Study of wound infection in Pakisthan institute of medical sciences. Ulus trauma. 2001;7(2):96-9.
Wilson JA, Clark JJ. Obesity: impediment to postsurgical wound healing. Adv Skin Wound Care. 2004;17:426-35.
Anaya DA, Dellinger EP. The obese surgical patient: a susceptible host for infection. Surg Infect (Larchmt). 2006;7:473-80.
Sobande A, Eskandar M. Multiple repeat caesarean section: Complications and outcome. J Obstet Gynecol Can. 2006;8(3):193-7.
Shittu AO, Kolawole DO, Oyedepo EAR. A study of wound infections in two health institutions in lle-llf, Nigeria. Afr J Biomed Res. 2002;5:97–102.