Abstract:
BACKGROUND: Surgical Site infections are the second most frequently reported infections of all
nosocomial infections among hospital patients. Among surgical patients in obstetrics, Surgical Site
Infections were the most common nosocomial infections and the rate is higher in sub-Saharan Africa.
There has not been a study which documented the extent of the problem in the study area; hence the
objective of this study was to determine the surgical site infection rate among women having surgery for
delivery in obstetrics of Jimma University Specialized Hospital (JUSH) from April 1, 2009 to March 31,
2010.
METHODS: A prospective descriptive study design was conducted with the aim of determining the
surgical site infection rate on all 770 women who had surgery for delivery from April 1, 2009 to March
31, 2010 in obstetric ward of the Hospital. Data on history of the patient, patient specific demographic
information on potential risk factors and the occurrence of Surgical Site infections in the first 30 days
following surgery were collected using pretested data collection form. In addition, relevant data were also
abstracted from the operation logbook of the cases. Then data were cleaned, edited and fed to computer
and analyzed using SPSS for window version 16.0. Finally Statistical test for significance was employed
using chi-squared (X 2) where appropriate at 5% level of significance.
RESULTS: The mean (±SD) of the subjects’ age was 26(±7) years and the majority of the women were
from the rural areas (72.7%). The overall surgical site infection rate was 11.4%. Of those who had
surgical site infections, 64.8% had clean-contaminated wound and 35.2% had contaminated /dirty
wounds. Wound class at time of surgery has a statistically significant association with Surgical Site
infections (p <0.001).The Surgical Site infections rate was similar for cesarean section and abdominal
hysterectomy but higher for destructive delivery under direct vision. Majority of the operations were
made for emergency Obstetric conditions (96.6%) and the Surgical Site Infections rate was two times
higher compared to that of elective surgery. Chorioamnionitis, presence of meconium, large
intraoperative blood loss and Perioperative blood transfusion were associated with increased severity of
SSIs with p < 0.001. Absence of antenatal care follow up was also associated with increased severity of
Surgical Site Infections.
CONCLUSION: it has been revealed that Surgical Site Infections rates are higher than acceptable
standards indicating the need for improving Antenatal care, increasing the number of skilled birth
attendants at the local clinics, increasing basic and comprehensive emergency obstetric care services,
applying improved surgical techniques and improving infection prevention practices to decrease
infection rate to acceptable standard.
