Surgical site infections following caesarean section at Royal Darwin Hospital, Northern Territory.

Katie Henman, Claire Gordon, Tain Gardiner, Jane Thorn, Brian Spain, Jane Davies, Robert Baird

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    7 Citations (Scopus)

    Abstract

    Surgical site skin infections (SSIs) are a preventable complication of delivery via caesarean section (c-section). After observing a high rate of SSIs following c-section, we reviewed SSIs following c-section over a 14-month period. In addition, we assessed all women undergoing c-section during the final 6 months of the study period to determine the risk factors for SSIs in our population. During the review period, 6.9% (40 of 583) of women developed a SSI following c-section. The rate of SSIs was five times higher in Indigenous women compared with non-Indigenous women (16.6% v. 3.3%, P=0.001). Diabetes mellitus, high ASA score and the use of staples to close the wound were also associated with SSIs (6 of 18 v. 24 of 199, P=0.02; 2 v. 1, P=0.003; 10 of 18 v. 49 of 199, P=0.002). Length of stay was increased by 4 days in women who had the SSI diagnosed during their initial admission (P=0.001), and a quarter of women with a SSI required readmission. Sixty-four percent (18 of 28) of isolates were Staphylococcus aureus, of which 44% were community-associated methicillin-resistant S. aureus (8 of 18). Twenty-nine percent of isolates were not susceptible to cephazolin, the standard antimicrobial prophylaxis used. After changing surgical skin preparation to alcoholic 2% chlorhexidine, adding gentamicin to cephazolin for preincisional antibiotic prophylaxis and educating staff, the rate of SSIs halved to 3.3%. Many of the SSIs that occurred after the new measures were introduced were in women who had not received gentamicin prophylaxis, highlighting the importance of ongoing staff education.

    Original languageEnglish
    Pages (from-to)47-51
    Number of pages5
    JournalHealthcare Infection
    Volume17
    Issue number2
    DOIs
    Publication statusPublished - 2012

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    Henman, K., Gordon, C., Gardiner, T., Thorn, J., Spain, B., Davies, J., & Baird, R. (2012). Surgical site infections following caesarean section at Royal Darwin Hospital, Northern Territory. Healthcare Infection, 17(2), 47-51. https://doi.org/10.1071/HI11027