Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries

Narang, Ridhi; Nandmer, Gurpreet Kaur; Sapkal, Rekha

doi:10.18203/2320-1770.ijrcog20171422

Cited by 4 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Narang et al in their study made a similar observation and found that 47% of their caesarean cases developed SSI had a previous scar. 17 Of the 112 major gynecological cases in this study, 6.25% developed ISSI (Table 1), lower than 10.5% reported by Naphade et al in their study. 18 Our policy of administration of pre-operative intravenous antibiotic in every case could have accounted for this difference.…”

Section: Discussioncontrasting

confidence: 61%

Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

Chandra

Saxena

2020

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: To find the incidence of incisional surgical site infection (ISSI) in obstetric and gynecological procedures, the risk factors, the microbial spectrum, the antibiotic sensitivity and the impact on the hospital stay. Methods: A prospective observational study was done under the department of obstetrics and gynecology, Era’s Lucknow medical college and hospital. All consecutive patients who underwent caesarean section, vaginal delivery with episiotomy, laparotomy, and hysterectomy were included in this study. Laparoscopic surgeries were excluded. Results; In this series of 646 surgeries, 6.18% developed ISSI. In the category of major surgeries, the ISSI rate was 8.89%. Amongst the 185 episiotomies 1.6% gaped. Anemia, diabetes mellitus, excess body weight, emergency or elective surgery, rapid built up of hemoglobin with blood transfusion, previous caesarean scar and tobacco intake were the risk factors identified. Coagulase negative staphylococcus was the dominant microbe. Antibiotic sensitivity to linezolid was found in 50% of the ISSI cases followed by amikacin, clindamycin and some others. The mean hospital stay was 13 days while the maximum was 26 days.Conclusions: The study established the current status of incisional surgical site infections, identified the risk factors, the microbial spectrum, the antibiotic sensitivity and the need for further studies using a preventive approach.

show abstract

Section: Discussioncontrasting

confidence: 61%

Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

Chandra

Saxena

2020

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Reasons that enhance risk to postoperative wound dehiscence incorporate age, obesity, nutritional status, preoperative medical disorders like anemia, diabetes, jaundice, use of steroids, poor intraoperative preparation, emergency or elective surgeries, duration and type of surgeries, postoperative wound site contamination or increase in intra-abdominal pressure, infection, etc. 4 Skilled appraisal and a methodical consideration of the physiological needs for wound healing allow to appreciate why some wounds heal quickly and others are slow to heal. 9 Earlier researchers have proposed that antimicrobial prophylaxis reduces the peril of endometritis and incisional SSI when correctly administered.…”

Section: Discussionmentioning

confidence: 99%

“…There is a strong need to avoid these impediments by properly addressing the factors incorporated in the development of wound dehiscence. 4 The wound gaping problem has started occupying scientific concern revealed by different explorations conducted from time to time. Clinicians have used various combinations of antibiotics as a single-dose chemoprophylaxis in gynecological surgery.…”

Section: Discussionmentioning

confidence: 99%

“…3 Appraisal of factors responsible for surgical site infection in obstetric patients is important. [4][5][6] Strategiesfor prevention of wound infections have been suggested from time to time. 7 The rising incidence of wound gape in the postoperative period is a humungous challenge to the obstetricians and gynecologists despite many amendments in the protocols for the preoperative, intraoperative, and postoperative management of the patient time and again.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of Wound Dehiscence Following Obstetric and Gynecological Surgeries at a Tertiary Care Hospital: A Retrospective Study

Patil¹,

Metgud²,

Kataria³

et al. 2020

Journal of South Asian Federation of Obstetrics and Gynaecology

View full text Add to dashboard Cite

Aim: A retrospective analysis with an aim to find out the incidence of wound dehiscence following obstetric and gynecological surgeries was carried out at a referral hospital and to review some of the practices in the hospital surgical and postoperative care of the surgical wound. Materials and methods: This study was carried out in the Department of Obstetrics and Gynecology at KLEs Dr Prabhakar Kore Charitable Hospital, a tertiary referral hospital in Belagavi, Karnataka, India, from May 2016 to August 2017 by obtaining data from medical records in the hospital. Results: During the study period, 3,172 women underwent major obstetric and gynecological surgeries; out of which 97 women developed wound dehiscence (3.05%). A total of 82 women had wound dehiscence following obstetric surgeries (84.54%) and 15 women following gynecological surgeries (15.46%). The number of emergency surgeries were 79 (81.44%), which included emergency lower segment cesarean section (LSCS) and the elective cases were 18 (18.56%), which comprised of elective LSCS, tubal ligation, and gynecological surgeries. Conclusion:The aim of this study was to review some of the practices during surgery and postoperative care in our hospital. The practice of scrubbing the abdomen prior to the day of surgery was followed. Subcutaneous fat suturing before closing the skin with subcuticular sutures was never practiced even when the fat layer was quite thick. Dressing was routinely changed on the 3rd day in the postnatal ward (exposing the wound to dirty linen particles when the wound had still not healed). However, preoperative antibiotics were routinely given prior to incision and also postoperative antibiotics for a total of 5 days. Clinical significance: Intraoperative and postoperative factors are significant in wound healing in addition to patient factors. Dressing should probably be done first only on the 5th postoperative day, which may prevent introduction of infection.

show abstract

“…Factors which increase an individual's risk to post operative wound gaping include age, obesity, nutritional status, preoperative medical disorders like anaemia, diabetes, jaundice, use of steroids, poor intra operative preparation, emergency or elective surgeries, duration and type of surgeries, post operative wound site contamination, increase in intra-abdominal pressure, wound infections etc. 4 Hence this observational study has been undertaken to estimate the incidence of SSI, the factors associated with the occurrence of SSI and their antibiotic sensitivities in post operative wards.…”

Section: Introductionmentioning

confidence: 99%

Post operative wound gape in obstetric and gynaecological surgeries

Vijay,

Chilkund,

Siddhi Kore

et al. 2023

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Despite advances made in asepsis, post operative wound infection is one of the major causes for increased postoperative morbidity and huge economic burden for patient and healthcare. This study was undertaken to identify risk factors for the post operative wound gaping in obstetrical and gynaecological surgeries. Methods: Retrospective observational study was conducted in the department of obstetrics and gynaecology of Pt. Madan Mohan Malviya Shatabdi hospital, Govandi, Mumbai for the year 2022. Results: 1611 cases were analysed that underwent various obstetrical and gynaecological surgeries. Post operative wound gaping incidence was 1.5 %. Most of the cases were seen in less than 34 years of age. 21% of cases reported with wound gaping and discharge within 5-7 days of surgery while 79% of cases reported gape after 7 days of surgery. 54% cases with wound gape were obstetric. The most commonly known associated risk factor was found to be diabetes mellitus (12.5%) followed by anaemia (8.3%), obesity (4.2%) and hypertension (4.2%). 62.49% of post operative surgical wound gape were multiparous. It is seen that in all these cases of wound gape the subcutaneous tissue was sutured separately as a layer with absorbable suture material- Vicryl no 1-0 or Vicryl no 2-0. Conclusions: Factors affecting post operative wound gaping are diabetes mellitus, anaemia, hypertension, obesity, chemoprophylaxis given prior to surgery, surgical method of wound closure and type of surgery. Standard wound closure techniques, correction of the avoidable known risk factors would provide a better outcome.

show abstract

Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries

Cited by 4 publications

References 8 publications

Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

Incidence of Wound Dehiscence Following Obstetric and Gynecological Surgeries at a Tertiary Care Hospital: A Retrospective Study

Post operative wound gape in obstetric and gynaecological surgeries

Contact Info

Product

Resources

About