Incidence of post cesarean section wound infection in a tertiary hospital, Riyadh, Saudi Arabia

OBJECTIVE: To measure the rate of wound infection after cesarean section and assess risk factors for such infection.

METHODS: A prospective surveillance was conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, during the period January 2000 through to December 2000. This included a total of 754 cesarean sections. The following risk factors, which were studied included, age, parity, gravida, gestational age, antenatal care, type of cesarean section emergency or elective, previous history of cesarean section, duration of operation, rank of surgeon, use of antibiotics, wound infection, complications and length of stay in the hospital. Post discharge surveillance was carried out 5-10 days later to check for wound infection.

RESULTS: The overall wound infection rate was 4.5% (95% confidence interval [CI], 3-6%). In the multivariate analysis, the independent risks factors for wound infection were age of the mother less than 20 years (Odds ratio (OR)=12.13: 95% CI 1.43-118.50: P=0.039), the duration of surgery, more than one and a half hour (OR=23.9: 95% CI 10.36-55.78: P=<.001) and medical complications namely diabetes mellitus (OR=2.28: 95% CI 1.01-5.05: P=0.03). There was a statistical significant relationship between wound infection and length of stay (P<0.001).

CONCLUSION: A protocol for prophylactic antibiotics is needed, in addition to a new strategy to reduce the nosocomial infection, in order to decrease the incidence of wound infection after cesarean section.