Operating Theatre Research Articles

Validation of hospital environmental disinfection efficiency of herbal fumigants

Background: Healthcare associated infections includes infestation by bacteria, viruses and fungi. As per WHO estimates, approximately 15% of all hospitalized patients suffer from these nosocomial infections caused by these micro-organisms. Outbreaks of such infections increases the use of antibiotics, vitamins and immonomodulator medicines. During ancient times, to prevent spread of infections; fumigation with herbs was a practice and it is still seen continued. Material & methods: Good quality herbal fumigants like Guggulu gum-resin, turmeric powder, spikenard rhizome, white mustard fruits, caraway fruits, camphor resins and cow’s ghee were used for fumigation of various hospital rooms like out-patient department room, dental clinic, gynecological procedure room, physiotherapy and operation theatre of Community Healthcare Center, Sarsa. Swabs from these units were tested for bacterial and fungal load before and after experiment by using culture media’s like nutrient broth and potato dextrose agar respectively. Results: The bacteria culture reported organisms namely Bacilus subtilis, Bacilus megaterium, Staphylococcus aureus, Micrococcus luteus and fungi like Aspergillus niger, mucor and rhizophus. After 30 minutes of fumigation procedure, significant reduction in bacterial colonies was found in gynecological procedure room, dental clinic, OPD and physiotherapy room while statistically non-significant results were observed in operation theatre. Two hours after fumigation, statistically significant result was observed in bacterial count in all studied units except operation theatre while fungal colonies reduction was achieved in all studied units. Conclusion: Fumigation shall be encouraged in hospital units like out patients department, wards and minor procedure rooms but may not be perfectly suitable for operative theatres always. The study encourages daily herbal fumigation of home and surroundings for hygienic and pleasant environment.

Impact of Novel Coronavirus Pandemic on Emergency and Elective Surgical Practice: A Retrospective Study in a Tertiary Care Center

Coronavirus disease 2019 (COVID-19) pandemic has led to a significant worldwide impact on general surgical practice. Since the beginning of this pandemic, hospitals have become a hot zone for the transmission of coronavirus. Routine and emergency surgical services have been severely disrupted worldwide due to this pandemic and may continue to be so for some time if more mutations take place in the virus. As of February 27, 2022, at 9 a.m., 43.5 crore positive cases were confirmed worldwide with over 6 million deaths. In India, 42,916,117 positive cases were confirmed to this date with 513,756 deaths. The impact of the COVID-19 pandemic on surgery daily practice and surgical patients was very high. There was a high impact on elective, semi-elective, cancer surgery, transplant programs, and education programs in our institution during the COVID-19 era. The most common reasons were being reduced number of availabilities of non-COVID-19 beds in the general surgical ward, difficulty in separating COVID-19 and non-COVID-19 patients, high transmission, and infection rate of COVID-19, reduced number of surgical intensive care unit beds and operation theatre due to allotment of these exclusively for COVID-19 patients. The reduced number of staff and health-care workers due to posting in the COVID-19 ward was also a major factor in the reduced number of electives and other surgeries in our institution. We need to find ways to continue providing essential medical services to patients while fighting this pandemic since it might take longer than expected to end. The present report summarizes the impact of the COVID-19 pandemic on our surgical services and the changes that we have adopted for better care of surgical patients and safe surgical practice to provide valuable information worldwide. This article also summarizes current evidence and recommendations for changes to surgical practice in our hospital according to the World Health Organization, Ministry of Health and Family Welfare, Indian Council of Medical Research, and Centers for Disease Control and Prevention guidelines to minimize the effect of the COVID-19 pandemic on surgical services.

Implant tuberculosis: A rare but possible cause in nonhealing surgical wound!

Tuberculosis is most commonly involving lungs and less than 20% cases were showing extrapulmonary involvement. Tuberculosis at surgical site is described in medical literature with very few cases in caesarean section surgical incision site. Implant tuberculosis is first time described in literature and is defined as “tuberculosis developed after implantation of mycobacterium tuberculosis bacilli by artificial means without involvement of primary organ or secondary lymphatic and/or hematogenous dissemination.” Caesarean section delivery is a common method of delivery of baby. Surgical site infections resulting to slowly healing to nonhealing wound are commonly reported and usually depend on various factors. Patient factors are immune status and comorbidities of patient. Hospital management factors such as operation theatre infection control policies, sterilization techniques for surgical instruments, and local wound care methods are established and implemented by hospital staff. In this case report, a 34-year-old female with history of caesarean delivery 1 month back presented with nonhealing wound at surgical site. We have done surgical repair with biopsy of wound margins. Wound discharge microscopy was negative for acid fast bacilli with few Gram-positive cocci. Cartridge-based nucleic acid amplification testes were positive for mycobacterium tuberculosis genome. Histopathology shows tuberculous pathology and underlying chronic infectious process for nonhealing wound. We have offered antituberculosis treatment (ATT) as per protocol and observed healing of tuberculous ulcer after 3 months with reappearance of ulcer in the 4th month of ATT. We have topically applied isoniazid and streptomycin over tuberculous ulcer along with systemic ATT. Tuberculous ulcer has responded and noted “cure” as completely healed surgical wound after 6 months of ATT.

A Survey of the Factors Affecting Theatre Turnaround Time in Kenyatta National Hospital Main Theatres

Operating theatres are heavily budgeted departments in health facilities. Theatre turnaround time (TAT) is used as one modality in determining the efficiency of health service delivery. Factors that correlate with TAT in the Kenyan setting are largely unknown. The main objective of this study was to determine the factors affecting turnaround time in Kenyatta National Hospital's main theatres.

Mean Best Corrected Visual Acuity after Intravitreal Bevacizumab in Patients with Diabetic Macular Edema

Purpose: To determine mean best corrected visual acuity after intravitreal bevacizumab in patients with diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Jinnah Hospital, Lahore and Chaudary Muhammad Akram Hospital Lahore from March 2018 to May 2021. Methods: A total of 200 patients of either gender with diabetic macular edema and age between 40 and 60 years were included in this study. Patients with dense cataract, corneal opacity, uncontrolled diabetes mellitus and those who were treated with pan retinal photocoagulation were excluded. Best corrected Visual Acuity (BCVA) was evaluated with Snellen chart and converted to log MAR. A standard protocol of 0.05 mL of Bevacizumab was prepared from injection Avastin, 100 mg/4 mL vial. Bevacizumab injection was given to all patients, using topical anesthesia, under aseptic measures in the operation theater. A total of 03 injections were given at 1-month interval. After three months, BCVA was recorded. Results were presented in number and percentages. Results: Mean age of the participants was 50.42 ± 6.48 years. Male to female ratio was 1:1.6, with 78 (39.0%) men and 122 (61.0%) women. Mean duration of diabetes mellitus was 5.12 ± 2.23 years. Mean pre-treatment BCVA was 0.51 ± 0.05 and mean post-treatment BCVA at three months was 0.26 ± 0.22. Conclusion: Mean BCVA is increased after intravitreal injection of Bevacizumab in patients with diabetic macular edema.

Intraoperative airborne bacterial contamination and covered sterile instrument tables: Is the standard two-drape method better than the single-drape method? Experimental study

BackgroundWe purposed to assess and compare the effectiveness and safety of covering with the single-drape method versus the standard two-drape method recommended by the Association of Perioperative Registered Nurses (AORN) in reducing contamination of the prepared sterile instrument tables (PSITs) with airborne bacteria-carrying particles (ABCPs). MethodsSix agar plates (n = 810) were used to measure the load of ABCPs on each PSIT both at rest (static period) and during a simulated surgical operation (dynamic period). At every time point, this arrangement was repeated two times during data collecting (81 PSITs were established in total). Experimental groups contained PSITs covered with the single-drape and the standard two-drape methods or no cover. We collected the plates after 60, 120, 180, 240 min, and 24 h. ResultsAt all-time points, covering the PSITs during static and dynamic operating theater (OT) conditions led to a meaningfully reduced load of ABCPs on the PSITs (P < 0.05). Moreover, no differences were found between the recommended two-drape method by the AORN and the single-drape method (P > 0.05). ConclusionCovering the PSITs during nonuse and active surgeries helps prevent the PSITs from becoming contaminated and thus can help decrease the incidence of surgical wound infection (SWI). Covering the PSITs with a sterile drape helps protect them from ABCPs that may be shed from the hair and skin of OT nurses (OTNs). Our study showed no priority for using the standard two-drape method compared with the single-drape method.

Anaphylaxis vis a vis operation theatre trauma: role of forensic investigation in alleged medical

Anaphylaxis vis a vis operation theatre trauma: role of forensic investigation in alleged medical

Operation Theatre Nurses’ Job Satisfaction in a Teaching Hospital in Mangalore - A Case Study

Purpose: Operation theatre management has always been a challenging aspect for any hospital administrator because it includes staff from various categories, a large amount of infrastructure, maintenance work, risk management, infection control priorities, and, most importantly, patient safety. Nurses play a crucial part in the healthcare team. Nursing work is demanding. Nurses work to prevent illness, promote health, and extend people's lives and the lives of the community. Nurses are involved in patient care, doctor care, and administrative care. Nurses' job satisfaction is crucial for healthcare institutions because it influences both the nursing care quality and patients' satisfaction. Design/methodology/approach: The research approach adopted is a descriptive study approach. Findings/Result: The individual's satisfaction levels can be influenced and shaped by various factors. Due to rising labor costs and the enormous shortage of nurses, satisfaction in the nursing job sector is a very important but also a crucial challenge for healthcare organizations. The key importance is the motivation of this discipline (Nurses) so that their involvement in the hospitals they work and practice their profession will be as satisfactory as possible. The aspects that affect a nurse's satisfaction with their work in operation theatres were identified to be appreciable salary with increment, duty time management, experienced staff as peers, reduced workload &amp; stress, more leave privileges, teamwork, the advanced technology at work, in-service education &amp; training, and more respect at their place of work, from the study as perceived by the operation theatre nurses’ themselves. Originality/value: Employee job satisfaction is the level at which an individual is content with a range of variety in their work, like the overall nature of their work. However, a person's needs and personality traits also have a role in their level of job satisfaction. Paper Type: Case study

What defines a great surgeon? A survey study confronting perspectives.

The definition of a great surgeon is usually reported by surgeons themselves. The objective of the study was to define a multifaceted definition of a great surgeon, by confronting patients', healthcare workers', and surgeons' perspectives. An online open-ended questionnaire was created to identify three qualities and three shortcomings defining a great surgeon. Age, gender, and profession of respondents were collected. Responses with a similar meaning were combined into word groups and labeled within four themes: human qualities, technical surgical skills (TSS), non-technical skills (NTS), and knowledge. Multivariate analyses were conducted between themes and respondent characteristics. Four thousand seven hundred and sixty qualities and 4,374 shortcomings were obtained from 1,620 respondents including 385 surgeons, 291 patients, 565 operating theater (OT) health professionals, and 379 non-OT health professionals. The main three qualities were dexterity (54% of respondents), meticulousness (18%), and empathy (18%). There was no significant difference between professional categories for TSS. Compared with surgeons, non-OT health professionals and patients put more emphasis on human qualities (29 vs. 39% and 42%, respectively, p < .001). OT health professionals referred more to NTS than surgeons (35 vs. 22%, p < 0.001). Knowledge was more important for surgeons (19%) than for all other professional categories (p < 0.001). This survey illustrates the multifaceted definition of a great surgeon. Even if dexterity is a major quality, human qualities are of paramount importance. Knowledge seems to be underestimated by non-surgeons, although it essential to understand the disease and preparing the patient and OT team for the procedure.

The Effect of Various Temperatures on the Inflammatory Profile of Fat Graft Storage: An Experimental Study.

Fat tissue has been widely used as a filler material during plastic surgery, but unpredictable fat retention remains a significant concern. Fat tissue is vulnerable to ischemia and hypoxia, but it always has waiting time before injection in the operation theater. Apart from transferring fat tissue as quickly as possible after harvesting, washing the aspirate with cool normal saline is often used. However, the mechanisms of cool temperature acting on adipose tissue have yet to be fully elucidated. Herein, this study aims to explore the effect of preservation at different temperatures on the inflammatory profile of adipose tissue. Inguinal adipose tissue of rats was collected and cultured in vitro under 4°C, 10°C, and room temperature for 2 hours. The proportion of damaged adipocytes and an array of cytokines were determined. We observed that the damage rate of the adipocyte membrane was slightly higher at room temperature, but there was no significant difference, while we noticed increased IL-6 and MCP-1 levels in adipose tissue at room temperature ( P ＜0.01). The 4°C and 10°C cool temperatures may offer protection against proinflammatory states during the adipose tissue preserved in vitro.

A noninferiority trial on information-based video versus self-selected video distraction technique for preoperative anxiety reduction in school children: Prepare trial.

Distraction techniques using smartphones to watch cartoon videos and play videogames have been successfully used to reduce preoperative anxiety in school children. However, the literature about the use of video-based preoperative information technique for anxiety reduction in that age group still remains understudied with conflicting results. We hypothesized that there would be no meaningful difference in anxiety score at induction period between the information-based video versus self-selected video distraction technique. Eighty-two children between 6 and 12 years undergoing surgery were randomized to self-selected video (n = 41) and information-based video (n = 41) distraction group in this prospective, randomized, noninferiority trial. Children in self-selected video group were shown video of their choice using smart phones, while children in the information-based video group were shown video of operation theater (OT) set up and induction procedure. The children were taken inside operating room along with parents watching the respective videos. Modified Yale Preoperative Anxiety Scale (m-YPAS), just before induction of anesthesia was recorded as the primary outcome. Induction compliance checklist score, anxiety of the parents, and short-term postoperative outcomes in 15 days (telephonically) were recorded as secondary outcomes. The mean difference in the baseline mYPAS score (95% CI) between the two groups was -2.7 (-8.2 to 2.8, p = .33) and -6.39 (-12.74 to -0.44, p = .05) just before the induction period. The upper bound of the 95% CI did not cross the value of 8, which was the noninferiority margin decided prior to study commencement. 70.73% cases had perfect induction in the self-selected video distraction group, compared to 68.29% in the information-based video group. After 15 days of postoperative follow-up, participants in the self-selected video group had a larger proportion of negative outcomes (53.7%) compared to information-based video group (31.7%), p = .044. Information-based technique using smart phone is non inferior to self-selected video-based distraction-based technique in decreasing PA with an additional advantage of decreasing postoperative short-term negative outcomes. CTRI identifier: CTRI/2020/03/023884.

Walking the Walk: A Review of Medical Students’ Perspective of a Surgical Theatre as the New Classroom

Medical school trains eligible students for a medical degree (MD). As part of the clinical years in the MD program, students attend surgical theatre sessions to learn medical concepts from hands-on experience in the theatre. This review aims to provide a comprehensive overview of the role surgical theatre plays in the learning process and clinical experience of medical students. Google Scholar, PubMed and NCBI databases were searched for articles from 1990 to March 2022 using the search terms ‘Operating Room’ or ‘Operating Theatre’ or ‘Surgical Theatre’ and ‘Learning’, ‘Medical Students’ and ‘Surgeons’. Only articles on medical students’ perceptions on their learning experience in the surgical theatre were included. Thirty-four articles were eligible for inclusion. Unpreparedness, anxiety, lack of clear learning outcomes, fear and intimidation were the most common reported experiences by students. These demotivate medical students from attending theatre, along with poor surgical field visibility, resulting in a negative learning experience. Positive experiences during theatre time were more likely to attract students to choose a future surgical career. Limitations include the inclusion of surgical residents’ perspectives and the exclusion of other surgical team members’ perspectives. Studies included students across different clinical years, and results were primarily based on subjective perceptions. Evidently, the surgical theatre is a great learning opportunity for medical students. However, for this learning environment to be beneficial, students need to be included during surgical discussions and procedures. Additionally, clear learning outcomes need to be present whilst adequately training students prior to their first surgical attendance.

Doing our bit to save the planet: Identifying and abandoning low value surgery.

Doing our bit to save the planet: Identifying and abandoning low value surgery.

Frequency of CSF Leak after Primary Repair of Incidental Durotomy in Lumbar Spine Surgery with use of Fibrin Glue

Aim: To find the frequency of CSF leakage after primary repair of incidental durotomy in lumbar spine surgery with use of fibrin glue. Study Design: Descriptive case series. Place and duration of study: Neurosurgery Unit 2, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore from 25-02-2021 to 25-08-2021. Methodology: Sixty five patients admitted for lumbar spine surgery and informed written consent was taken. All the cases were operated in elective operation theatre. Valsalva maneuver was performed per-operatively in all patients to assess CSF leakage. In all patients having incidental durotomy diagnosed per-operatively, primary repair with Prolene 4-0 was done and sealed with fribrin glue. Patients were examined on daily basis for CSF leakage. In case of no complication, patient was discharged on day 07 after surgery. In case of CSF leakage on clinical examination, MRI spine was done. After discharge, patient was followed in OPD on weekly basis for 30 days. CSF leak was done as per operational definition. Results: Total of 65 patients, 41(63.1%) were in age group of 16-40 years and 187(36.9%) were in age group of 41-75 years and mean age was calculated as 38.93±11.47 years. There were 44(67.7%) were male whereas 21(32.2%) were females. Frequency of CSF leakage was 9(13.8%) after primary repair of incidental durotomy in lumbar spine surgery with use of fibrin glue. Practical Implication: We found that frequency of CSF leakage was 13.8% after primary repair of incidental durotomy in lumbar spine surgery with use of fibrin glue. The rate of CSF leakage is low. Therefore, we concluded that fibrin glue is useful for the treatment of incidental durotomy in lumber spine surgery. Conclusion: This study showed that the CSF leakage was 13.8%. As the rate of CSF leakage is low. Therefore, we concluded that fibrin glue is useful for the treatment of incidental durotomy in lumbar spine surgery. Keywords: Cerebrospinal Fluid Leak, Incidental Durotomy, Lumbar Spine Surgery.

Successful neuraxial blockade under lumbar X-ray guidance in patients with ankylosing spondylitis: A series of 3 cases

Ankylosing spondylitis poses several anesthetic challenges ranging from difficult airway to difficult neuraxial blockade. Limited cervical spine mobility, restricted opening of the temporomandibular joint, and cardiorespiratory compromise makes neuraxial anesthesia the preferred technique in these patients. However due to the ossification of the interspinous ligament and ligamentum flavum, and also syndesmophytes between adjacent vertebrae, neuraxial anesthesia poses its own set of challenges. We present a series of 3 cases in which a preoperative lumbosacral X-ray spine and fluoroscopic guidance in the operation theater allowed for an easy and more effective technique for neuraxial anesthesia in ankylosing spondylitis patients posted for transurethral resection of prostate.

Perception of Canadian ophthalmologists on immediately sequential bilateral cataract surgery: insights and implications

ObjectifÉvaluer la perception des ophtalmologistes canadiens en ce qui a trait à la chirurgie de la cataracte bilatérale immédiatement séquentielle (CCBIS). NatureSondage anonyme envoyé à tous les membres actifs de la Société canadienne d'ophtalmologie. MéthodesOn a ainsi obtenu de l'information sur les aspects suivants : données démographiques de base, types de pratique professionnelle en lien avec la chirurgie de la cataracte, avantages, inconvénients et préoccupations en lien avec la CCBIS. RésultatsAu total, 352 ophtalmologistes ont répondu au sondage. De ce nombre, 94 répondants (27 %) réalisent régulièrement des CCBIS, 123 (35 %) réalisent des CCBIS à titre exceptionnel et 131 (37 %) ne réalisent jamais de CCBIS. Les ophtalmologistes qui réalisent des CCBIS sont significativement plus jeunes que ceux qui n'en réalisent jamais (p < 0,001) et sont actifs depuis moins longtemps (p < 0,001). La prévalence des ophtalmologistes qui réalisent des CCBIS varie significativement en fonction de la province (p < 0,001) : la plupart des ophtalmologistes qui réalisent couramment des CCBIS proviennent du Québec (n = 44; 48 %), endroit où les mesures de dissuasion financière sont les moins corsées au pays. Les CCBIS sont le plus souvent réalisées dans des centres universitaires (n = 39; 42 %), plutôt que dans des cliniques privées ou communautaires (p < 0,001). Le principal motif justifiant le recours à la CCBIS tient à une utilisation plus efficace des blocs opératoires (n = 142; 65 %). Le risque de complications bilatérales (n = 193; 57 %) et l'absence de résultats réfractifs dans le premier œil au moment de réaliser l'intervention dans le deuxième œil (n = 184; 52 %) constituent les préoccupations principales en lien avec la CCBIS. La pandémie de COVID-19 a eu un effet positif sur la perception de 152 répondants (43 %) à cet égard; il s'agit surtout des ophtalmologistes qui réalisaient déjà régulièrement des CCBIS (n = 77; 84 %). ConclusionsLes ophtalmologistes qui réalisent des CCBIS sont susceptibles d’être plus jeunes et de travailler dans des centres universitaires. Le Québec a la prévalence la plus élevée d'ophtalmologistes qui réalisent des CCBIS. En raison de la pandémie de COVID-19, les ophtalmologistes qui réalisaient déjà des CCBIS se sont mis à en réaliser encore plus, comparativement à ceux qui n'en réalisaient jamais.

Ready-To-Use and Rapidly Biodegradable Magnesium Phosphate Bone Cement: In Vivo Evaluation in Sheep.

In clinical practice, hydroxyapatite (HA) cements for bone defect treatment are frequently prepared by mixing a powder component and a liquid component shortly before implantation in the operation theater, which is time-consuming and error-prone. In addition, HA cements are only slightly resorbed, that is, cement residues can still be found in the bone years after implantation. Here, these challenges are addressed by a prefabricated magnesium phosphate cement paste based on glycerol, which is ready-to-use and can be directly applied during surgery. By using a trimodal particle size distribution (PSD), the paste is readily injectable and exhibits a compressive strength of 9-14MPa after setting. Struvite (MgNH4 PO4 ·6H2 O), dittmarite (MgNH4 PO4 ·H2 O), farringtonite (Mg3 (PO4 )2 ), and newberyite (MgHPO4 ·3H2 O) are the mineral phases present in the set cement. The paste developed here features a promising degradation of 37% after fourmonths in an ovine implantation model, with 25% of the implant area being newly formed bone. It is concluded that the novel prefabricated paste improves application during surgery, has a suitable degradation rate, and supports bone regeneration.

A Bi-Objective Paediatric Operating Theater Scheduling

In this paper, a bi- objective Operating Theater scheduling is proposed. The problem is subject to order and assignment constraints. The first objective is the minimization of the operating theater opening total time also called makespan in manufacturing systems while the second is to maximize constraints satisfaction. The scheduling problem is considered as a two-stage hybrid flow shop with blocking. Several metaheuristics are compared: the firefly algorithm, bats algorithm, particles swarm optimization and local search. In addition to the care specific qualitative and quantitative parameters, the average deviation from the lower bound is used in order to confirm the effectiveness of the methods. The implementation is done on the operating theater of the paediatric hospital of Oran when it is properly and improperly sized.

Monitoring of Air and Water Bacterial Load in the Operation Theatres and Intensive Care Units of Selected Hospitals in Dhaka city: A Cross-Sectional Study

Background: Hospital milieu monitoring is an essential component for controlling healthcare associated infections (HCAIs) as it serves as the reservoir for pathogenic microbes. Aim of this study was to identify the bacterial load in Intensive care units (ICU) and Operation theaters (OT) air and water sources of selected tertiary care hospitals. Material &amp; Methods: The study was organized in Microbiology department, BIRDEM General Hospital. A sum total 28 air samples &amp; 6 water samples were collected from three selected hospitals and those were processed according to the set of protocols. Results: From air sampling, highest load of bacteria was found 480 CFU/dm²/hr in Hospital C ICU, 38.40 ± 9.99 CFU/dm²/hr in pre-OT samples &amp; 218.2±43.35 CFU/dm²/hr in intra OT samples of Hospital C. From water sampling, unacceptable level of coliforms was found in all three hospitals. Among the non-pathogens, 24% – 37% Micrococcus spp. (normal flora) and 2% -18% Bacillus spp. (contaminants) were found in the OTs. Whereas pathogens found were Acinetobacter spp. (20.7%) followed by Pseudomonas spp. (19.4%), Klebsiella spp. (12.1%) &amp; S. aureus (9.2%) in the ICUs. Conclusion: It could be deduced from the study that environmental sources such as air and water contaminations with multidrug resistant pathogens are an ultimate risk factor for all related to the healthcare settings, specially the indoor patients.

Timely initiation of breastfeeding and its factors among women delivered via cesarean section under spinal anesthesia at the University of Gondar Comprehensive Specialized Hospital, north-west Ethiopia, 2021: a hospital-based cross-sectional study.

This study aimed to determine the timely initiation of breastfeeding and its factors among women delivered via CS under spinal anesthesia. Institutional-based cross-sectional study was employed among 422 systematically selected mothers from April to June 2021. Data were collected by a structured questionnaire. Data entry and analysis were done using Epi Data and Stata version 14.0. Binary logistic regressions were computed to identify factors. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare statistical significance. Delayed initiation of breastfeeding (DIBF) was 41.8%. Mothers who had an emergency CS (AOR =2.13, 95% CI [1.21-3.75]), had less than four antenatal care (ANC) follow-ups (AOR=1.77, 95% CI [1.02-3.13]), had moderate to severe pain during the perioperative period (AOR=2.65, 95% CI [1.24-5.54]), primipara (AOR=1.89; 95% CI [1.20-3.25]), used intraoperative opioid medications (AOR=1.86; 95% CI [1.01-3.30]), and had no skin-to-skin contact (AOR=2.1, 95% CI [1.27-3.51]) were associated with DIBF. DIBF after cesarean delivery was high. Emergency CS, less than four ANC visits, immediate postoperative pain, and lack of skin-to-skin contact were factors associated with delayed breastfeeding. Health care providers, especially anesthetists, in the operation theater, should implement multimodal analgesics and minimize opioid consumption. Moreover, they should keep the newborn in skin-to-skin contact to initiate breastfeeding in the operation theater soon after birth.