Risk Factors Associated With Postcaesarean Wound Sepsis At The Lagos University Teaching Hospital, Lagos.
C C Uzoho, E R Ola, M T Niemogha And T Odugbemi

SUMMARY

Objective: To identify the factors that put patients at risk of developing wound infection following caesarean section, the possible causative agents and their antibiotic sensitivity patterns.

Patients and Method: A group of 125 consecutive patients that underwent caesarean delivery at Lagos University Teaching Hospital, Lagos, Nigeria were followed up and studied with regard to wound infection and sequelae. All the patients were treated post-operatively with antibiotics for five days. Wounds were inspected on 5th post-operative day and swabs taken. All isolates were tested for antibiotic sensitivity using the disc diffusion method. Statistical analysis was carried out to determine risk factors and the level of significance was set at p < 0.05. Results: Twenty-one (16.8%) patients out of the 125 patients developed wound sepsis. Gram-negative organisms were the predominant pathogens isolated and they were mainly susceptible to the fluoroquinolones and third generation cephalosporins. Significant risk factors for wound sepsis were prolonged duration of surgery, prolonged duration of labour, early rupture of membranes, anaemia and obesity. Wound sepsis was found to be associated with prolonged hospital stay. No maternal death was associated with wound sepsis.

Conclusion: Effective antenatal care, strict asepsis, good surgical technique and effective supervision of labour are required to avoid wound sepsis. It is also suggested that an appropriate use of the third generation cephalosporin as prophylaxis will go a long way in reducing the incidence of post caesarean wound sepsis.