Higher Surgical Site Infection Rates After Obstetrics than Gynecology Procedures

Surgical site infection (SSI) is a healthcare-associated infection occurring in wounds after surgical procedures. Its incidence ranges from 0.5-15%, depending on the type of surgery and the patient's condition. 

A new study aimed to identify risk factors for SSIs, common causative organisms, and antibiotic susceptibility.

This study was conducted by the Departments of Obstetrics and Gynecology and Microbiology at Agartala Government Medical College. The study involved 300 patients undergoing various surgeries - who were monitored until the 30th postoperative day for signs of infection.

The SSI incidence was 9.3%, with all cases presenting as superficial infections. E. coli was the most common pathogen (21%), followed by Staphylococcus aureus and Pseudomonas aeruginosa. E. coli showed high susceptibility to amikacin and resistance to ciprofloxacin. Identified risk factors included anemia (3.6%), prolonged premature rupture of membranes (7.1%), diabetes (10.7%), gestational diabetes (3.6%), gestational hypertension (7.1%), and obstructed labor (17.9%). Most patients underwent emergency surgery (p=0.0425). Among infected cases, 53.6% had transverse incisions, and 46.4% had vertical incisions. The mean hospital stay before surgery was 2.60±4.79 days, and the mean day of SSI onset was 7.92±2.05 days postoperatively. Secondary suturing was required in 32.2% of cases.

SSI rates were higher in obstetric surgeries compared to gynecological procedures. Identifying multiple risk factors can aid in SSI risk stratification. Active surveillance and strict infection control measures are essential to reduce SSI rates. Future studies with larger sample sizes and molecular analysis of drug-resistant pathogens are recommended for more robust conclusions.

Source: Debnath S, Rakshit AK, Paul DP. Study of surgical site infection among patients undergoing obstetrics and gynaecological operation in a teaching institute. Int J Clin Obstet Gynaecol. 2024;8(6):110-117.