Prevalence and Risk Factors for Post Cesarean Delivery Surgical Site Infection in a Teaching Hospital Setting in Rural Rwanda: A Prospective Cross Sectional Study

ISSN: 2319-7706 Volume 5 Number 6 (2016) pp. 631-641 Journal homepage: http://www.ijcmas.com Cesarean delivery (CD) is one of the commonest surgeries worldwide. Surgical site infection (SSI) is one of the complications which arises later on in the postoperative period with an incidence five to twenty times that of vaginal delivery. Knowing the prevalence of SSIs and its risk factors is important in improving infection prevention and control in our setting. This study aimed to assess the prevalence and risk factors for post CD SSI in the department of Gynecology and Obstetrics ofButare University Teaching Hospital (CHUB). This is a prospective cross sectional study, where women who had CD at CHUB during the study period were followed up for duration of thirty days. Before discharging them from the hospital, all SSI signs and symptoms were discussed. The surgical sites were inspected once on discharge day and the dressing was removed. Data was collected using a questionnaire which was filled out by the study nurse. A telephone interview was carried out in two occasions at 15 and 30 day after discharge inquiring about SSI symptoms and signs. Were also instructed to call anytime if she had any signs or symptoms of infection. A total of 323 women who had CD were recruited and followed up for 30 days. No participants were lost during the follow up. They were 16 total SSI for a prevalence of 4.9%. The majority of infections were superficial surgical site infection (75%) and most of the infections developed after discharged (62.5%). There were 2 deep SSI and 2 organ SSI and no infection related maternal deaths. Significant association was found between prolonged labor and SSI development. No significant association was noted with duration of surgery, rupture of membranes and obesity. Elective CD (53.6%) comprised the majority of operation. Staphylococcus aureus (62.5%) was the predominant organism isolate in microbiological studies. Subcuticular suture was the most skin type closure without increasing risk of SSI. Prophylactic antibiotics and Abdominal and thigh pre preparation for surgery with Alcohol firstly and secondly povidone were used in 100% of our study population. The prevalence of SSI at CHUB was found to be high at 4.9% on women undergoing CD and prolonged labor was found to be significantly associated risk of developing SSI. Use of mobile telephone after proper explanation of signs and symptoms of SSI to women underwent CD was a best post discharge tools for SSI evaluation. K ey wo rd s Surgical site infection, cesarean delivery, risk factors, post discharge surveillance. Accepted: 23 May 2016