Objectives: The aim of the study was to determine the frequency of surgical site infection (SSI), the etiological factors and its management in elective and emergency cesarean sections.

Methods: This prospective study was conducted on women who underwent caesarean section at GMC, Haldwani from 1 st August 2012 to 31st July2013. Two groups were made. Group –I comprised of 128(15.50%) cases that underwent elective caesarean sections while group – II comprised of 698(84.50%) cases that were unbooked and presented in emergency. The surgical aseptic technique was same in both the groups including antibiotic prophylaxis. All the patients were admitted for at least 5 days postoperatively and abdominal dressings changed on 3rd postoperative day and on 5th day before being discharged, follow-up was done on 8-10th day including assessment for surgical site infections. Infections that met standard case definitions were identified during hospital stay and follow up within 30 days of operation.

Results: A total 826 patients underwent elective/emergency caesarean section for various indications, out of which, 74 patients had surgical site infections. The frequency of surgical site infection in group – I was 2.34% (n=3) and in group – II 10.17% (n=71). Of the total 74 cases of SSI in both the groups, 61 (82.43%) were superficial in nature, 13(17.57%) deep. 86% of the infections occurred after hospital discharge. 20 of these women were rehospitalised and 11 were reoperated. The commonest isolate was E. coli (28%) followed by Staphylococcus aureus (20%) and coagulase negative Staphylococcus (17%). 23.8% of Staphylococcus aureus strains were MRSA.

Conclusion: A proper assessment of risk factors that predispose to SSI and their modification may help in reduction of SSI rates. Frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors affecting these practices.

Key Words – Surgical site infection, Caesarean section, Wound infection

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