Incidence and risk factors for post caesarean delivery surgical site infection in a tertiary care hospital

Smita S. Naik, Ajit Nagarsenkar


Background: Post-operative surgical site infection (SSI) is the most commonly reported nosocomial infection which constitutes a major public health care problem worldwide. SSI are the one of the most common complication after caesarean section (C-sec) and results in maternal morbidity and mortality, increased length of the hospital stays and economic burden. The aim of the study is to determine the incidence and risk factors of SSI in women undergoing C-sec.

Methods: The prospective observational study carried out in department of Obstetrics and Gynaecology in Goa medical college, Bambolim Goa from 1st November 2017 to 30th May 2019. Collection of data was carried using predesigned and pretested proforma. SSI was examined for association of different risk factors and its distribution.

Results: During this study period, 2106 patients underwent C-sec, out of which 103 patients developed post-operative SSI with the incidence rate being 4.89%. The incidence rate was found higher in emergency cases (6.55%) as compared to that of elective (1.21%) and median time to SSI was the 6th post- operative day. Majority of SSI, i.e., 102 out of 103 (99.08%) were superficial SSI, 1 (0.98%) were deep SSI and no organ/space SSI. The highest rate of SSI was found in 21-34 years of age group (84.47%). The common risk factors associated are anaemia, diabetes, hypertension and obesity.

Conclusions: SSI results from multiple risk factors which include modifiable and non- modifiable factors and thorough analysis of these factors can help prevent SSI. The medical staff should focus on some of the modifiable risk factors can be eliminated by strict antisepsis, timely prophylactic antibiotic and maintaining normothermia as well as optimal glucose level.


SSI, C-sec, Deep SSI, Superficial SSI

Full Text:



Ferroz EM, Bacelar TS, Aguiar JLA, Ferraz AAB, Pognossin G, Batista JEM. Wound infections rates in clean surgery. Inf contr Hosp epidem, 1999;13:457-62.

Leaper DJ. Surgical infection. Bailey and Love’s short practice of surgery 25th edition. 2004;32-48.

World Health Organisation. Global guidelines of prevention of surgical site infection. 2016. Available at: http//

Black JD, De Haydu C, Fan L, Sheth SS. Surgical site infection in gynaecology. Obstet Gynecol Surv. 2014;69(8):501-10.

Shah F, Gandhi M, Mehta V, Udani D, Mundra M. Nosocomial Infections in Surgical Wards. Internet J Surg. 2009;24:1.

Mandell GL, Bennett JE, Dolin R. Practice of Prevention of Postoperative Infection. In: Mandell, Bennett, and Dolin: Principles and Practice of Infectious Diseases (6thedtn), Churchill Livingstone, Elsevier, Florida, USA. 2005;3540-5.

Smaill FM, Gyte GML. Antibiotic prophylaxis versus no prophylaxis for preventing infection after caesarean section. Cochrane Database Syst Rev. 2010;CD007482.

Smaill FM, Hofmeyr GJ. Antibiotic prophylaxis for caesarean section. Cochrane Database Syst Rev. 2002;CD000933.

Bizimana JB, Ndoli J, Bayingana C, Baluhe I, Gilson GJ, Habimana E. Prevalence and risk factors for post caesarean delivery surgical site infection in a teaching hospital setting in rural Rwanda. Int J Curr Microbiol appl sci. 2016:5(6):631-41.

Dhamecha M, Chauhan N, Kavathia G, Goswami Y, Gosai K. Incidence and predictors of surgical site infection, a study at tertiary care hospital. GCSMC J Med Sci. 2014;3.

Mpogoro FJ, Mshana SF, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean section at Bugando Medical centre, Mwanza, Tanzania. Antimicrobial resistance infect control. 2014;3:25.

Mamo T, Abebe TW, Chichiabellu TY, Anjulo AA. Risk factors for surgical site infections in obstetrics: a retrospective study in an Ethiopian referral hospital. Patient Safety Surg. 2017;11:24.

Bhadaura AR. Clinical study of post-operative wound infection in obstetric and gynaecological surgeries in a tertiary care set up. Int J Reprod Contracept obstret Gynecol. 2013;2,631-8.

Naphade SA. Study of Surgical Site Infections following Gynaecological Surgeries in a Tertiary Care Hospital; MVP. J Med Sci. 2017;4(2):186-92.

Pathak A, Mahadik K, Swami MB, Roy PK, Sharma M, Mahadik VK et al. Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India. Antimicrobial Resistance Infect Control. 2017;6:66.