Neha Gangane

Abstract

Context: Surgical Site infections (SSI) is the most common form of hospital acquired infection and proper surveillance is needed to comprehend the incidence and risk factors. Preventing SSIs is possible with proper strategic planning for appropriate interventions. Materials and Methods: Hospital information system was used to identify women undergoing gynecological surgeries over a period of 2 years from January 2016 to December 2017 and information of women with surgical site infections (SSI) was noted and analyzed to determine the incidence and factors affecting SSI at a tertiary care rural hospital in central India. Results: The incidence of SSI was 0.75% of 10629 surgeries. Age over 45 years, low socioeconomic status, prolonged surgical time, and increased BMI were common risk factors. Febrile morbidity, pain and discharge from wound and distension of abdomen led to the suspicion of SSI. The mean length of postoperative stay for patients with SSI was longer by 6.72 days compared to patients without SSI (13.74 days vs. 7.02 days). More than 75% women undergoing surgery had mild anaemia at the time of operative procedure. SSI following cesarean section was low as compared to abdominal hysterectomy. Anemia (27.5%) and presence of infective focus (23.75%) were found to be the commonest risk factors for SSI followed by obesity (12.5%) and history of previous abdominal surgery (10%). Staphylococcus aureus (26.25%) was the commonest organism cultured from the infective site. Conclusion: In the present study, incidence of SSI in gynecological surgeries was found to be low, depicting a good infection prevention protocol in the existing system Proper infrastructure, maintaining ideal operation theater environment, adequate preoperative assessment, proper surgical preparation & donning SOPs and post-operative monitoring were the key factors for success. Keywords: Surgical site infections, Gynecological surgeries, Surveillance, Morbidity.

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