Investigating the Prevalence and Causes of Surgical Site Infection and Surgical Wound Dehiscence After Cesarean Delivery: A Cohort Study in Zeynab Hospital in Shiraz-Iran

Abstract

Background: Surgical site infection (SSI) and surgical wound dehiscence are among the main causes of readmission and an increase in treatment costs for patients undergoing cesarean section (CS) surgery. The present study aimed to investigate the prevalence and causes of SSI and surgical wound dehiscence after cesarean delivery in Zeinab hospital in Shiraz-Iran from January 2020 to August 2021. Methods: This prospective cohort study was conducted on 130 pregnant women who underwent CS in Zeinab hospital, Shiraz. All culture media were examined 24 and 48 hours after culturing. In addition, 10-14 days after the operation, patients were followed up by telephone to update data on their wound condition. The results were analyzed using descriptive statistics, χ2 , and logistic regression by SPSS 22. Results: The mean age of patients was 31.94 (5.59) years, and 57.7% of pregnant women had one history of previous CS. The prevalence of SSI infection after cesarean delivery was 20.76%, which is relatively high. Age (odds ratio [OR]=1.04, P≤0.001), weight (OR=1.09, P≤0.001), body mass index (OR=1.11, P≤0.001), the education level (OR=1.02, P≤0.001), history of previous CS (OR=2.79, P≤0.001), and the number of childbearing (OR=1.68, P≤0.001) were identified as predictive factors of SSI after CS. The culture results of 27 SSI patients (20.76%) were positive. Further, five out of 27 patients (18.51%) with SSI experienced complete wound dehiscence and were readmitted, and the other 22 patients (81.48%) only experienced SSI and received outpatient care. Conclusion: Among the factors affecting SSI, the history of previous CS played the main role in causing the infection. Pre- and post-cesarean care plays a major role in SSI and surgical wound healing. Moreover, it is necessary to continuously monitor and evaluate the implementation of infection control protocols and personnel and surgeons’ hand scrub in the operating room.