A prospective study of wound infections after laparotomy in obstetrics and gynaecology department.

Postoperative wound infection is of great importance to both surgeon and patient. All surgeons know that postoperative wound infection means morbidity, anxiety, longer hospitalization, higher cost; not to forget the embarrassment to the surgeons. However, it is still a common surgical complication despite other advances in modern medicine. This study was conducted to find out the incidence of postoperative wound infection and to survey the risk factors for wound infection in obstetrics and gynaecology department of Nepal medical college teaching hospital (NMCTH). A prospective study of all the cases with infected wound after laparotomy and lower segment cesarean section done in NMCTH in obstetrics and gynaecology department was carried out in this study from Chaitra 2068 to Falgun 2069. The frequency of wound infection was 5.87%. Most of the wound infection after lower segment cesarean section occurred in emergency cases (16 out of 19). Seventy percent of patients had preoperative hospital stay range of 0-2 days whereas the range was 3-18 days for the rest 30%. The range of blood loss was 150-300 ml in nearly 75.7 % of patients. Duration of operation was 1-2 hours in 89.2% cases. Only 48.6% of wound infection was identified within 8th postoperative day. Number of infected cases getting prophylactic antibiotic was 25 (67.6%). BMI was >25 in 62.2% of patients. Type of skin incision was pfannenstiel in 94.6%. Skin was closed subcuticularly with vicryl no. 1 in 81.1%. Staphylococcus aureus was isolated in swab culture in 24.3%. Resuturing was required in 18.9% of cases.