Surgical Site Infection in Obstetric and Gynecological Surgeries: A Prospective Observational Study

Abstract

IntroductionAn infection at an incisional site that develops within 30 days after surgery, or within a year if a prosthetic is implanted, is referred to as a surgical site infection (SSI). They are mainly caused by exogenous and/or endogenous microbes that penetrate the surgical site during surgery (primary infection) or after the procedure (secondary infection). The prevention of SSI should be the ultimate goal of the surgery team and hospital administration. MethodologyThe prospective observational study of SSI consisted of 920 patients who were admitted and underwent surgery between April 2021 and September 2022. After a complete examination, a detailed proforma for the collection of data pertaining to patients in this study was prepared, and patients were included as per the inclusion and exclusion criteria. ResultsThe study demonstrated significant results in terms of the association of body mass index (BMI), hemoglobin, and blood sugar level with the SSI status (p<0.05) and nonsignificant results in terms of emergency/elective surgery, type of surgery, and type of incision (p>0.05). ConclusionThe overall rate of SSI was 9.2% in the present study. The major reasons involved are inadequate infrastructure facilities, different antibiotics policies, and non-uniform pre-, intra-, and post-operative measures that add woes and result in an increased incidence of SSI. In the present study that was undertaken at a teaching and tertiary care center, the SSI incidence is comparatively lower, but with the implementation of correct knowledge and technique, the rate can further be reduced to a large extent.

Cambio rutinario de instrumental y guantes quirúrgicos en cirugía abdominal: ¿cuál es el impacto sobre el riesgo de infección?

“…Las bacterias gramnegativas son las relacionadas con mayor frecuencia con esta complicación en cirugía general, esencialmente Esc h e ri c h i a co l i , Kl e bsi e l l a p n e u m o n ia , y St a p hy l o co cc u s a u re u s . (22)(23)(24) El uso adecuado del equipo de protección personal, también se ha asociado con la aparición de ISO, especialmente en casos de cirugía de emergencia, donde el tiempo de preparación y prehabilitación quirúrgica es muy corto. (25) Se sugiere que, principalmente en estos casos, sobre todo cuando el paciente presenta antecedentes de diabetes mellitus, inmunosupresión o alcoholismo, se use el equipo de protección personal completo por parte del equipo quirúrgico.…”

Prophylactic Antibiotics before Gynecologic Surgery: A Comprehensive Review of Guidelines

“…They are some of the most frequent healthcare-associated infections (HAIs) and are associated with longer postoperative hospital admissions, additional surgical operations, treatment in critical care units, and increased death rates [ 2 ]. It is estimated that 8–10% of patients undergoing gynecologic surgery will develop infectious complications, such as infection of the urinary tract, the surgical wound, or the perineum, endometritis, vaginal cuff cellulitis, and sepsis [ 3 ]. The risk of developing a postoperative infection depends on various factors, including the inherent level of microbiological contamination of the surgical site, the nature of the surgical procedure, and specific patient variables and clinical features.…”

“…Antibiotic therapy should be instituted if there is reason to suspect infection risk or if the findings upon the procedure indicate risk of infection, e.g., dilated fallopian tubes or pelvic inflammatory disease 2. An alternative regimen is metronidazole 2 g po prior to the procedure PLUS 1 g azithromycin po prior to the procedure for patients at a high risk of infection 3. Consider screening for STIs and treatment according to guidelines.…”

“…Dosage is based on the patient's actual body weight. If the patient's actual weight is more than 20% above ideal body weight (IBW), the "dosing weight" (DW) can be determined as follows: DW = IBW + 0.4 (actual weight-IBW) 3. Pharmacokinetic parameters may be higher in obese patients, but often not proportional to total body weight 4.…”

Microbiology and drug sensitivity of Surgical Site Infections in Pakistan: A Systematic Review

“…3,4 SSI are reported in every speciality of surgery with variable frequencies and different outcomes. 5,6,7 Various bacterial pathogens are reported to cause SSI 7 . The management of SSI is becoming a challenge due to increasing drug resistance of microorganisms.…”