Efficacy of targeted monitoring on surgical site infection following caesarean section

Abstract:

ObjectiveTo understand the occurrence of surgical site infection (SSI) following caesarean section, analyze risk factors, implement intervention measures, and evaluate intervention efficacy. MethodsAll puerperas who underwent caesarean section in the obstetric department of a hospital from January to December 2013 were monitored, investigation were performed in two stages: evaluation stage (JanuaryJune, 2013) and intervention stage (JulyDecember, 2013). Targeted intervention and clinical intervention were combined to intervene the risk factors. Occurrence of SSI, length of hospital stay, and hospitalization expense before and after intervention were compared. ResultsA total of 1 593 patients with caesarean section were monitored, 31(1.95%) had SSI, incidence of SSI in evaluation stage and intervention stage were 3.40% and 0.95% respectively；incidence of SSI before and after intervention was significantly different(χ2=12.02，P＜0.01). Univariate analysis on evaluation stage showed that risk factors for SSI in patients with caesarean section were duration of operation ≥1 hour, body mass index ≥26 kg/m2, intraoperative blood loss ≥300 mL, underlying diseases, premature rupture of membranes, and without antimicrobial prophylaxis (all P<0.05). In evaluation stage, 648 patients received postoperative antimicrobial prophylaxis for>48 hours (n=395, 60.96%); in intervention stage, 945 patients received postoperative antimicrobial prophylaxis for<24 hours (n=776, 82.12%), different time distribution of postoperative antimicrobial prophylaxis in two stages after intervention was compared, difference was statistically significant（χ2=673.26，P＜0.01）. The mean length of hospital stay of 31 SSI patients were (13.83±3.26) days, nonSSI patients were (7.06±1.66) days, difference was statistically significant (t=7.86, P<0.01); the average hospitalization expenses for patients with SSI were (9 044.77±2 649.19) yuan, nonSSI patients were (6 254.73±638.52) yuan, difference was statistically significant (t=4.344, P<0.01). ConclusionIntervention measures for risk factors of SSI after caesarean section can effectively reduce the incidence of SSI in caesarean section.