Surgical Site Infection in Cesarean Section Childbirth at Al-Istishri Arab Hospital in Ramallah رسالة ماجستير

Abstract

Introduction: Surgical site infection (SSI) is the infection that occurs after a specific period of time of the surgery, and it can involve outer skin layers (superficial), the internal organs, or implanted material. In caesarean section (CS), SSI is an important phenomenon to care for, and is associated with multiple risk factors and consequences. This study aims to investigate for the prevalence of superficial SSI among mothers who underwent CS, as well as the corresponding factors, most common signs and symptoms and preventive measures among Palestinian mothers. Methodology: A retrospective cross-sectional design was used, and a structured electronic questionnaire that was developed by infection control department at Al-Istishari Arab Hospital (IAH), by gathering data about mothers’ demographic data, medical and obstetric history, SSI and its signs and symptoms, and preventive measurements from a randomized sample of 198 CS cases in 2019 records. Main results: 58.6% of CS are elective, with mean age of mothers of 29.08 years old, and a gravidity mean of 2.63 times and parity of 1.22 times. Prevalence of SSI among CS cases in IAH is 15.7% in 2019, with signs of fever (4%) localized pain (10.1%), swelling (6.1%) and heat (2.5%), open wound (6.6%) and wound discharges (11.6%), and is less than other hospitals and the global rate. SSI prevalence was not significantly associated with CS type (p-value = 0.949) or any of the demographic data, while it was significantly correlated with wound care after operation (p-value < 0.001). Conclusion: While SSI prevalence is less than other hospitals, more preventive measures can be used to decrease it more, like the use of chlorhexidine solution for dressing rather than iodine, as well as the compliance with recommended protocols of prophylactic antibiotics prescription. Moreover, more studies are recommended to be conducted in other hospitals and for the investigation of further risk factors associated with SSI.