PREVENTION OF POST OPERATIVE INFECTIONS IN EMERGENCY CAESAREAN SECTIONS: ROLE OF SURGICAL BUNDLE AND VAGINAL CLEANING

Abstract

Introduction: Caesarean section (CS) is one of the commonest surgical procedures performed in obstetrics. Postoperative infectious complications including surgical site infections (SSI) are a cause of significant morbidity after CS as compared to vaginal delivery. Aim: To assess the role of application of surgical bundle and vaginal cleaning before caesarean section in preventing postoperative infectious complications. Design: Prospective randomised interventional study. Place and duration of study: Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and hospital,Aligarh from November 2016 to October 2018. Methodology: Total of 216 patients undergoing emergency CS in the hospital was enrolled in the study. Patients were kept in 2 groups. In group 1, women undergoing emergency C-Section whom conventional preoperative preparation was done using savlon-povidone iodine as skin antiseptic and a 7 day postop prophylactic antibiotic regime was administered.In group 2,surgical bundle and vaginal cleaning was done but postop prophylactic antibiotic regime was reduced to 3 day Results:Overall,SSIs were most common infectious morbidity in both groups with highest incidence in group 1(14.7%) and lower in group 2(7.01%), and the difference was statistically significant. Rates of endometritis, UTI and URTI were similar among 2 groups.Duration of hospital stay was lower for group 2 (6.43+_3.29days).No Significant association was noted between haemoglobin levels <8g/dl and number of >4 vaginal examinations with risk of development of SSI (p<0.05). Conclusion:Bundled approach including vaginal cleaning has decreased the incidence of SSIs after emergency CS but larger clinical studies are needed to prove the definite role