Risk Factors for Surgical-Site Infections Following Cesarean Section

Abstract

Among the variables identified as risk factors for SSI, only two have the possibility to be changed through interventions. Antibiotic prophylaxis would benefit all cesarean patients regardless of active labor or ruptured membranes and would decrease morbidity and length of stay. Women's healthcare professionals also must continue to encourage pregnant women to start prenatal visits early in the pregnancy and to maintain scheduled visits throughout the pregnancy to prevent perinatal complications, including postoperative infection.

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

“…68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultants Conclusion: 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. 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition.…”

Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section

“…Previous studies that had sufficient sample sizes and that used multivariate analysis to identify independent risk factors for SSI after cesarean section identified the following factors associated with increased risk of SSI: younger age; obesity; presence of hypertension or preeclampsia; diabetes mellitus; chorioamnionitis; preoperative infection at a remote body site; high preoperative severity of illness; nulliparity; fewer than 7 prenatal visits; longer interval since rupture of membranes; premature rupture of membranes; emergency delivery; ab- sence of antibiotic prophylaxis; longer duration of operation; use of staples for skin closure; and twin delivery. 3,7,8,19 The wide variety of reported independent risk factors for SSI may be due to the variability in potential risk factors selected for analysis. Killian et al 3 included only a very small number of potential risk factors, whereas other studies included a more comprehensive collection.…”

“…3,7,8,19 The wide variety of reported independent risk factors for SSI may be due to the variability in potential risk factors selected for analysis. Killian et al 3 included only a very small number of potential risk factors, whereas other studies included a more comprehensive collection. 7,8 Also, of the 4 studies that used multivariate analysis with sufficient sample size, 1 study conducted SSI surveillance only during the original surgical admission.…”

“…3,7,8,22 Possible biological explanations for this association include the relative avascularity of adipose tissue, 8,23 the increase in wound area, 24 and the poor penetration of prophylactic antibiotics in adipose tissue. 25 Our study calculated the BMI of patients from their weight and height at admission, because the prepregnancy BMI was not available for all patients.…”

“…1 The rates of SSI after cesarean section reported in the literature range from 3% to 15%, depending on the surveillance methods used to identify infections, the patient population, and the use of antibiotic prophylaxis. [2][3][4][5][6][7][8][9][10][11] The pooled mean rate of SSI after cesarean section for US hospitals participating in the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System is 3.15%. 12 Expanding our knowledge of the risk factors associated with SSI is essential to developing targeted prevention strategies to reduce the risk of SSI.…”