Objective: Surgical site infection (SSI) accounts for 31% of healthcare-associated infections and is associated with a 3% mortality rate. It increases the frequency of transition to the intensive care unit, the length of hospital stay, and the rate of read- missions. According to the National Health Service-Related Infections Surveillance Network 2017 data, the rate of infection in the surgical field in our country is 0.72%, and this rate is 1.0% in 25 of 60 types of surgery. Obstetric–gynecologic surgeries are in this group. Information on SSI after cesarean section is limited in the international and national literature. Our research is aimed to define the features of C-section SSI and contribute to the solution of the problems observed with the data to be obtained. Material and Methods: A retrospective evaluation of SSIs in patients who underwent C-sections between January 1, 2018, and December 31, 2020, at Zeynep Kamil Ma- ternity and Children’s Training and Research Hospital was conducted. Results: During the study period, SSI was observed in 191 (2.3%) of 8370 C-section cases, and the mean age of these patients was 30.5±6.3 years. Body mass index was at the level of 32.8±5.2 kg/m 2 and body mass index value was >30 kg/m2 in 88% of the SSI group. Emergency C-section was applied in 145 (75.9%) cases and elective C-section in 46 (24.1%) cases. The skin incisions were closed with multifilament in 174 (91.1%), monofilament in 14 (7.3%), and skin stapler in 3 (1.6%) patients. After the diagnosis of SSI, the povidone iodine dressing was sufficient for wound healing in 184 (96.3%) patients. Secondary healing method was applied to 4 (2.1%) patients and negative pressure wound closure technique was applied to 3 (1.6%) patients. Conclusion: In terms of SSI, it is recommended to perform a preoperative risk as- sessment for pregnant women and to show appropriate approaches to risky people. Providing wound care training to patients at discharge, timely postpartum controls, and standardizing wound care products to be used will increase the success rate. "> [PDF] Retrospective analysis of surgical site infections after cesarean section: Rates, microbiological profile, and clinical features | [PDF] Retrospective analysis of surgical site infections after cesarean section: Rates, microbiological profile, and clinical features Objective: Surgical site infection (SSI) accounts for 31% of healthcare-associated infections and is associated with a 3% mortality rate. It increases the frequency of transition to the intensive care unit, the length of hospital stay, and the rate of read- missions. According to the National Health Service-Related Infections Surveillance Network 2017 data, the rate of infection in the surgical field in our country is 0.72%, and this rate is 1.0% in 25 of 60 types of surgery. Obstetric–gynecologic surgeries are in this group. Information on SSI after cesarean section is limited in the international and national literature. Our research is aimed to define the features of C-section SSI and contribute to the solution of the problems observed with the data to be obtained. Material and Methods: A retrospective evaluation of SSIs in patients who underwent C-sections between January 1, 2018, and December 31, 2020, at Zeynep Kamil Ma- ternity and Children’s Training and Research Hospital was conducted. Results: During the study period, SSI was observed in 191 (2.3%) of 8370 C-section cases, and the mean age of these patients was 30.5±6.3 years. Body mass index was at the level of 32.8±5.2 kg/m 2 and body mass index value was >30 kg/m2 in 88% of the SSI group. Emergency C-section was applied in 145 (75.9%) cases and elective C-section in 46 (24.1%) cases. The skin incisions were closed with multifilament in 174 (91.1%), monofilament in 14 (7.3%), and skin stapler in 3 (1.6%) patients. After the diagnosis of SSI, the povidone iodine dressing was sufficient for wound healing in 184 (96.3%) patients. Secondary healing method was applied to 4 (2.1%) patients and negative pressure wound closure technique was applied to 3 (1.6%) patients. Conclusion: In terms of SSI, it is recommended to perform a preoperative risk as- sessment for pregnant women and to show appropriate approaches to risky people. Providing wound care training to patients at discharge, timely postpartum controls, and standardizing wound care products to be used will increase the success rate. ">
Pınar KUMRU, Sami AÇAR, Erman ÇİFTÇİ, Betül YILMAZER

3927

Retrospective analysis of surgical site infections after cesarean section: Rates, microbiological profile, and clinical features

Retrospective analysis of surgical site infections after cesarean section: Rates, microbiological profile, and clinical features

Objective: Surgical site infection (SSI) accounts for 31% of healthcare-associated infections and is associated with a 3% mortality rate. It increases the frequency of transition to the intensive care unit, the length of hospital stay, and the rate of read- missions. According to the National Health Service-Related Infections Surveillance Network 2017 data, the rate of infection in the surgical field in our country is 0.72%, and this rate is 1.0% in 25 of 60 types of surgery. Obstetric–gynecologic surgeries are in this group. Information on SSI after cesarean section is limited in the international and national literature. Our research is aimed to define the features of C-section SSI and contribute to the solution of the problems observed with the data to be obtained. Material and Methods: A retrospective evaluation of SSIs in patients who underwent C-sections between January 1, 2018, and December 31, 2020, at Zeynep Kamil Ma- ternity and Children’s Training and Research Hospital was conducted. Results: During the study period, SSI was observed in 191 (2.3%) of 8370 C-section cases, and the mean age of these patients was 30.5±6.3 years. Body mass index was at the level of 32.8±5.2 kg/m 2 and body mass index value was >30 kg/m2 in 88% of the SSI group. Emergency C-section was applied in 145 (75.9%) cases and elective C-section in 46 (24.1%) cases. The skin incisions were closed with multifilament in 174 (91.1%), monofilament in 14 (7.3%), and skin stapler in 3 (1.6%) patients. After the diagnosis of SSI, the povidone iodine dressing was sufficient for wound healing in 184 (96.3%) patients. Secondary healing method was applied to 4 (2.1%) patients and negative pressure wound closure technique was applied to 3 (1.6%) patients. Conclusion: In terms of SSI, it is recommended to perform a preoperative risk as- sessment for pregnant women and to show appropriate approaches to risky people. Providing wound care training to patients at discharge, timely postpartum controls, and standardizing wound care products to be used will increase the success rate.
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  • 1. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infec- tions in the acute care setting. Am J Infect Control 2008;36:309–32.
  • 2. Surgial Site Infection Event (SSI). Available at: https://www.cdc.gov/ nhsn/PDFs/pscManual/9pscSSIcurrent.pdf. Accessed Mar 19, 2019.
  • 3. Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017;152:784–91.
  • 4. Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA 2015;313:483–95.
  • 5. Lewis SS, Moehring RW, Chen LF, Sexton DJ, Anderson DJ. Assessing the relative burden of hospital-acquired infections in a network of com- munity hospitals. Infect Control Hosp Epidemiol 2013;34:1229–30.
  • 6. Owens PL, Barrett ML, Raetzman S, Maggard-Gibbons M, Steiner CA. Surgical site infections following ambulatory surgery procedures. JAMA 2014;311:709–16.
  • 7. Anderson DJ, Hartwig MG, Pappas T, Sexton DJ, Kanafani ZA, Auten G, et al. Surgical volume and the risk of surgical site infection in community hospitals: Size matters. Ann Surg 2008;247:343–9.
  • 8. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt) 2013;14:73–156.
  • 9. Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35:605–27
  • 10. Orr JW, Taylor PT. Wound healing. In: Complications in Gynecological Surgery: Prevention, Recognition, and Management. Philadelphia, PA: JB Lippincott; 2018. p.167.
  • 11. Lipscomb, GH, Ling, FG. Wound Healing, Suture Material, and Surgical Instrumentation. In: Rock, JA, Jones, HA, III editors. Te Linde’s Opera- tive Gynecology. 9th ed. Philadelphia, PA: JB Lippincott; 2003. p.233.
  • 12. Hedrick TL, Sawyer RG, Friel CM, Stukenborg GJ. A method for estimat- ing the risk of surgical site infection in patients with abdominal colorectal procedures. Dis Colon Rectum 2013;56:627–37.
  • 13. Dias M, Dick A, Reynolds RM, Lahti-Pulkkinen M, Denison FC. Predic- tors of surgical site skin infection and clinical outcome at caesarean sec- tion in the very severely obese: A retrospective cohort study. PLoS One 2019;14:e0216157.
  • 14. Zuarez-Easton S, Zafran N, Garmi G, Salim R. Postcesarean wound infection: Prevalence, impact, prevention, and management challenges. Int J Womens Health 2017;9:81–8
  • 15. Ketcheson F, Woolcott C, Allen V, Langley JM. Risk factors for surgical site infection following cesarean delivery: A retrospective cohort study. CMAJ Open 2017;5:E546–56.
  • 16. Moulton LJ, Munoz JL, Lachiewicz M, Liu X, Goje O. Surgical site infec- tion after cesarean delivery: Incidence and risk factors at a US academic institution. J Matern Fetal Neonatal Med 2018;31:1873–80.
  • 17. De Nardo P, Gentilotti E, Nguhuni B, Vairo F, Chaula Z, Nicastri E, et al. Post-caesarean section surgical site infections at a Tanzanian tertiary hospital: A prospective observational study. J Hosp Infect 2016;93:355– 9.
  • 18. Jasim HH, Sulaiman SAS, Khan AH, Dawood OT, Abdulameer AH, Usha R. Incidence and risk factors of surgical site infection among patients undergoing cesarean section. Clin Med Insights Ther 2017;9:1–7.
  • 19. Abdel Jalil MH, Hammour KA, Alsous M, Awad W, Hadadden R, Bakri FG, et al. Surgical site infections following caesarean operations at a Jordanian teaching hospital: Frequency and implicated factors. Sci Rep 2017;7:12210.
  • 20. Cardoso Del Monte MC, Pinto Neto AM. Postdischarge surveillance fol- lowing cesarean section: The incidence of surgical site infection and associated factors. Am J Infect Control 2010;38:467–72.
  • 21. Zejnullahu VA, Isjanovska R, Sejfija Z, Zejnullahu VA. Surgical site infections after cesarean sections at the University Clinical Center of Kosovo: Rates, microbiological profile and risk factors. BMC Infect Dis 2019;19:752.
  • 22. Altemeier WA, Burke JF, Pruitt BA, Sandusky WR. Manual on control of infection in surgical patients. Philadelphia: Lippincott; 1984.
  • 23. Yang J, Liu Y, Yan P, Tian H, Jing W, Si M, et al. Comparison of laparo- scopic cholecystectomy with and without abdominal drainage in patients with non-complicated benign gallbladder disease: A protocol for system- atic review and meta analysis. Medicine (Baltimore) 2020;99:e20070.
  • 24. O’Hara LM, Thom KA, Preas MA. Update to the centers for disease control and prevention and the healthcare infection control practices ad- visory committee guideline for the prevention of surgical site ınfection (2017): A summary, review, and strategies for implementation. Am J In- fect Control 2018;46:602–9.
  • 25. Kuper TM, Murphy PB, Kaur B, Ott MC. Prophylactic negative pressure wound therapy for closed laparotomy incisions: A meta-analysis of ran- domized controlled trials. Ann Surg 2020;271:67–74.
  • 26. Shiroky J, Lillie E, Muaddi H, Sevigny M, Choi WJ, Karanicolas PJ. The impact of negative pressure wound therapy for closed surgical inci- sions on surgical site infection: A systematic review and meta-analysis. Surgery 2020;167:1001–9.
  • 27. Bhangu A, Singh P, Lundy J, Bowley DM. Systemic review and meta- analysis of randomized clinical trials comparing primary vs delayed pri- mary skin closure in contaminated and dirty abdominal incisions. JAMA Surg 2013;148:779–86.
  • 28. Towfigh S, Clarke T, Yacoub W, Pooli AH, Mason RJ, Katkhouda N, et al. Significant reduction of wound infections with daily probing of con- taminated wounds: A prospective randomized clinical trial. Arch Surg 2011;146:448–52.
  • 29. Dumville JC, Gray TA, Walter CJ, Sharp CA, Page T, Macefield R, et al. Dressings for the prevention of surgical site infection. Cochrane Database Syst Rev 2016;12:CD003091.
  • 30. Global guidelines for the prevention of surgical site infection. World Health Organization 2016. Available at: https://www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0095752/pdf/PubMedHealth_PMH0095752.pdf. Ac- cessed Sep 19, 2017.
  • 31. Edwards JP, Ho AL, Tee MC, Dixon E, Ball CG. Wound protectors re- duce surgical site infection: A meta-analysis of randomized controlled trials. Ann Surg 2012;256:53–9.
  • 32. 2019 exceptional surveillance of surgical site infections: Prevention and treatment (NICE guideline NG125) [Internet]. London: National Institute for Health and Care Excellence (UK); Apr 11, 2019.
  • 33. Seidelman JL, Smith B, Shoff C, Baker AW, Lewis SS, Anderson DJ, et al. Serious superficial incisional surgical site infections (SSISSIs): A proposed surveillance definition. Infect Control Hosp Epidemiol 2019;40:1258–9.
  • 34. Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis 2005;41:1373–406.
  • 35. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gor- bach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis 2014;59:e10–52.
  • 36. May AK, Stafford RE, Bulger EM, Heffernan D, Guillamondegui O, Bochicchio G, et al. Treatment of complicated skin and soft tissue infec- tions. Surg Infect (Larchmt) 2009;10:467–99.
  • 37. Sawyer RG, Claridge JA, Nathens AB, Rotstein OD, Duane TM, Evans HL, et al. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med 2015;372:1996–2005.
  • 38. Weigelt JA, Lipsky BA, Tabak YP, Derby KG, Kim M, Gupta V. Surgical site infections: Causative pathogens and associated outcomes. Am J Infect Control 2010;38:112–20.
  • 39. Ovington LG. Hanging wet-to-dry dressings out to dry. Home Healthc Nurse 2001;19:477–83; quiz 484.
  • 40. Sharp CA, McLaws M. Wound Dressings for Surgical Sites (Protocol). In: Cochrane Wounds Group, editors. The Cochrane Library. Chichester, UK: John Wiley & Sons Ltd; 2001
Zeynep Kamil medical journal (Online)-Cover
  • ISSN: 1300-7971
  • Yayın Aralığı: Yılda 4 Sayı
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