Surgical site infection and associated factors among women underwent cesarean delivery in Debretabor General Hospital, Northwest Ethiopia: hospital based cross sectional study

Abstract

Background Cesarean section rates have been increasing dramatically during the past three decades and surgical site infections are becoming a leading cause of morbidity and mortality among women undergoing cesarean deliveries. However there is lack of sound evidence on both the magnitude of the problem and the associated factors in developing countries including Ethiopia. The purpose of this study was to assess proportion of surgical site infection and associated factors among women undergoing cesarean delivery in Debretabor General Hospital. Methods An institution based cross sectional study was conducted from May to December / 2017. All women delivered by cesarean section in Debretabor General Hospital during data collection period were our study population. Data were collected using Pre-tested, semi-structured questionnaire/ data extraction tool and post discharge phone follow up and analyzed using SPSS version 20. Logistic regression model was used to determine the association of independent variables with the outcome variable and odds ratios with 95% confidence interval were used to estimate the strength of the association. Results Proportion of surgical site infection among cesarean deliveries was about 8% (95%Cl: 5.4, 11.6). Pregnancy induced hypertension (AOR = 4.75, 95%CI: 1.62, 13.92), chorioaminitis (AOR = 4.37, 95%CI: 1.53, 12.50), midline skin incision (AOR = 5.19, 95% CI: 1.87, 14.37 and post-operative hemoglobin less than 11 g/deciliter (AOR = 5.28, 95%CI: 1.97, 14.18) were significantly associated with surgical site infection. Conclusions Pregnancy induced hypertension, chorioaminitis, midline skin incision and post-operative hemoglobin of less than 11 g/deciliter were independent factors associated with surgical site infection. Cesarean deliveries with concomitant pregnancy induced hypertension, chorioaminitis and post-operative anemia needs special care and follow up until surgical site infection is ruled out. It is also advisable to reduce generous midline skin incision and better replaced with pfannensteil incision.

Analysis of risk factors associated with caesarean section surgical site infections: a case control study

“…Molla et al found that SSI was significantly associated with midline skin incision than operations done via Pfannensteil incision. 12 Shreshtha et al also found similar association. In this study, in significantly more women with SSI, operative time was >1 hour.…”

“…Type of skin suturing was not associated with SSI. In comparison, Molla et al also reported that SSI was significantly associated with interrupted skin closure 12.…”

“…A high volume of blood loss is usually associated with poor control of bleeding, increased tissue damage from prolonged retraction and manipulation and more sutures. Molla et al reported that SSI was significantly associated with estimated blood loss (EBL) of greater than 500 ml 12. Cases group had significantly higher number of women in whom LSCS was performed by assistant professor.…”

Maternal caesarean section infection (MACSI) in Sierra Leone: a case–control study

“…However, the achievement of this high-quality standard requires important and significant investment in terms of public health organisation, surgical team training and structural improvements, all of which require a coordinated approach. Moreover, patients with low socio-economic status remain the most vulnerable in terms of post-caesarean infections and will always need more medical attention and follow-up [40][41][42].…”

Microbial Contamination after Cardiac Surgery in a Hospital Cardiac Surgery Ward

“…It seems that in all parts of the world, nosocomial infection cases are as important as in the US [ 4 ]. The rate of nosocomial infections in Iran ranges from 1.9% to 25% [ 5 ]. Among the various types of infections in the hospital, urinary tract infection, lower respiratory tract infections or pneumonia, surgical site infections, and digestive tract infections account for 42%, 15-20%, 24% and 5-10% of infections, respectively [ 6 ].…”