A Comparative study between subcutaneous wash and suturing among post Cesarean section infection

Abstract

Back ground: A post-cesarean wound infection is a bacterial infection in the surgical incision following an abdominal (cesarean or C-section) delivery. This complication develops in approximately 3 to 5% of women who have a cesarean delivery. Women who develop a postcesarean wound infection typically experience a moderately high fever and lower abdominal pain. A post-cesarean wound infection prolongs the hospital stay, usually by two days, and increases the hospitalization costs. In some cases, a wound infection can lead to severe complications, such as necrotizing fasciitis, rupturing of the fascia (the strength layer closed during surgery), or actual evisceration (opening of the wound, with the bowel protruding through the incision). Women who develop these complications must undergo at least one additional major operation and require a much longer time to recover. In rare instances, such complications have been fatal. Dealing with infections after cesarean sections is a serious business. Aims: To identify an effective method in minimizing post cesarean section infection rate. Method: A clinical trial study was carried out from the 1st of January 2009 to the 30th of December 2010 in Tikrit hospitals enrolled 200 cases who were subjected to Cesarean sections ,those cases were divided into 2 groups ,in the 1st group subcutaneous layer was leaved without suturing just washing with normal saline while in the second group this layer was sutured by catgut .Both groups were free from all factors that affect the outcome like age , parity or medical problems like diabetes mellitus and all cases were followed up after section to detect the postpartum infection in both groups. Results There was no significant difference between the mean age of both groups by using T-test in which the mean age ± standard deviation was for 1st group (27.6 ±2.95)year while for the 2nd group was (28±2.43)year. The difference in the average time for developing the post operative infection was found very significant (p< 0.05) between both groups so the 1st group developed the infection longer than the 2nd group (13.2 ±1.62)day,( 11.5± 1.82) days respectively .It was found that only 6 patients from 95 (6%) who were subjected to washing procedure developed infection while 69 from 97 (71%) developed infection from 2nd group who were subjected to suturing of subcutaneous layer & that was statistically significant . Conclusion: Washing of subcutaneous layer with normal saline without suturing was very effective than the usual method in decreasing the rate for developing postoperative infection and even need more time to develop after removing the dressing .