HARAMAYA UNIVERSITY COLLEGE OF HEALTH SCIENCES, SCHOOL OF MEDICINE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Abstract

Surgical site infection is defined by the Disease Control and Prevention criteria as an infection occurring within 30 days after the operation and involves the skin incision and subcutaneous tissue and/or the deep soft tissue of the incision or organ/space. Surgical site infection following cesarean section is a common cause of morbidity with a reported rate of 3- 15%. Methods and materials: A hospital based cross-sectional study was conducted from July 2021 to October /2021. All women delivered by cesarean section in Hiwot Fana specialized university Hospital during data collection period were my study population. Data were collected using structured questionnaire and checklist. Data processing and analysis was done using SPSS statistical software version 20. Bivariate and multivariable logistic regressions analysis performed to assess the association between dependent and independent variables. The degree of association between dependent and independent variables assessed using adjusted odds ratio with 95% confidence interval and P-value <0.05. Culture based microbiological method were used to identify causal agents in postoperative wounds. Results: prevalence of surgical site infection was 7.74% (95%CI: 7.68, 7.80). Rupture of membrane before operation (AOR=4.04, 95%CI: 1.52, 10.79), labore duration >24 hours (AOR=4.04, 95%CI: 1.52, 10.79), midline skin incision (AOR=3.76, 95%CI: 1.47, 9.58) and postoperative HGB<11g/dl (AOR=3.42, 95%CI: 1.32, 8.87) were significantly associated with surgical site infection. Staphylococcus aureus was the dominant isolated pathogen, followed by Escherichia coli. Conclusions: Rupture of membrane before operation, absence of ANC care, labore duration >24 hours, midline skin incision and postoperative HGB<11g/dl were independent factors. Cesarean deliveries with prolonged labor, prolonged rupture of membrane and post-operative anemia needs special care and follow up until surgical site infection is ruled out. It is also advisable to reduce generous midline skin incision and better replaced with pfannensteil incision