Publication:

Risk factors associated with post cesarean surgical site wound infection in Bangabandhu Sheikh Mujib medical university, Bangladesh

Background Caesarean section is one of the most commonly performed surgical procedures in hospitals. Surgical site infections are a common complication after a caesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, the dissatisfaction of patients, longer hospital stays as well as higher treatment costs.

Methods This prospective cohort was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh included 400 women (247 emergency CS, 153 elective CS) from September 2019 to August 2020. Data were collected through consent, medical record reviews, and questionnaires. SSI risk factors were assessed, and wound examinations were conducted before discharge. STATA 14.0 was used for analysis. Participants were educated about SSI symptoms and monitored for 30 days post-operation.

Results Nulliparous individuals were more common in the emergency CS group (61.5% vs. 32% in Elective CS). Ruptured membranes were higher in emergency CS (71.7% vs. 2.6% in elective CS). Prophylactic antibiotic usage differed significantly (88.7% in emergency CS vs. 3.9% in elective CS). Post-discharge wound infections were more prevalent in emergency CS (10.53% vs. 2.61% in elective CS). No significant differences were found in other parameters. High-risk factors included BMI >30 and operation time ≥45 min.

Conclusion SSI rates may be underestimated with limited hospital observation. Prolonged operation times (>38 min) and high BMI (>30) significantly increased SSI risk. Identifying high-risk subgroups and administering antibiotics accordingly can help prevent SSI and reduce unnecessary antibiotic use.