Incidence and associated risk factors for Surgical Site Infection following Emergency Caesarean Section: a retrospective case-control study

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Abstract

Objective: To assess the incidence, risk and associated factors that contribute to an acquired Surgical Site Infection (SSI) in emergency Caesarean Section (CS). Design: Retrospective case-control study. Setting: An acute District General Hospital in England. Participants: 206 patients (101 SSI patients and 105 non-SSI patients) who had emergency CS between January-December 2017. Methods: Grade of surgeon, smoking status, pre-operative vaginal swab status (positive or negative), diabetes status, age, body mass index (BMI), membrane rupture to delivery interval and length of surgery were recorded. Risk factors were identified using simple and multiple logistic regression. Results: BMI (kg/m2 13 ) was significantly associated with SSI incidence (odds ratio (OR) 1.17; 95% confidence interval (CI) 1.11 to 1.24; p<0.001). Substantive non-significant associations were recorded between SSI, patient age and vaginal swab status. Conclusion: BMI was the only significant risk factor for the development of an SSI in emergency CS, possibly due to the impact of excessive adipose tissue on the immune system and reduced effectiveness of antibiotics. Diabetes status, patient age and pre-op vaginal swab status were not significantly associated with SSI in emergency CS. Improved guidelines and strategies for managing at-risk patients would enable clinicians to manage emergency CS patients better and reduce the risk of SSI development. The importance of wound management including frequent wound cleaning, appropriate dressings, dressing changes and education is highlighted. Future research on larger samples should be conducted to validate these findings.
Original languageEnglish
JournalAdvances in Skin and Wound Care
Publication statusAccepted/In press - 5 Nov 2020

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