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Title: EARLY VS DELAYED DRESSING REMOVAL IN CAESAREAN SECTION FOR SURGICAL SITE INFECTION PREVENTION
e-poster Number: EP 269
Category: Maternal and Fetal Health
Author Name: Dr. Shayla Srivastava
Institute: Jankalyan hospital, Koparkhairane, Navi Mumbai
Co-Author Name:
Abstract :
Introduction The CDC defines SSI as an infection occurring within 30 days from the operative procedure in the part of the body where surgery took place.Our goal of this study was to investigate if there is a difference in outcomes like SSI in dressings that are left in place for 4 days v/s 8 days in Caesarean Sections. Aims and objectives The primary objective was to study if surgical dressing removal on Day 4 of caesarean section changes the incidence of postoperative wound infections in low risk mothers as compared to Day 8. The secondary objectives included ? Occurence of wound complications ? Occurence of febrile morbidity. ? Need of higher antibiotics. ? Need of secondary re-suturing. ? Exploration for pus drainage or burst abdomen. Materials Participants were studied in 2 groups. Group A (100 patient): Early dressing removal on Day 4 of caesarean section Group B (100 patients): Delayed dressing removal on Day 8 of caesarean section. A total of 200 patients (100 in group A and 100 in group B) posted for caesarean section. All women were enrolled on Day 4 of surgery. Exclusion criteria : 1. Age <18 years or >40 years. 2. Patients who had high risk pregnancies. 3. All those women who had febrile morbidities or SSI within 4 days of caesarean After dressing removal, participants were asked to take daily bath with soap and water. Women of both groups were discharged on Day 4. Results The primary outcome measure was presence of surgical site infections including superficial incisional infection (p value 0.70) and deep incisional infection (p value 0.40). The secondary outcomes included wound complications like seroma (p value 0.52), hematoma (p value 0.23), purulent discharge (p value 0.65), rate of swelling (p value 1), presence of febrile morbidity (p value 0.54), wound dehiscence (p value 0.65), need of interventions like daily dressing(p value 0.55), use of higher antibiotics (p value 0.5), need of resuturing (p value 0.65). Conclusion In relation to primary and secondary outcomes, our analysis suggested that there was no significant difference between early and late dressing removal in Caesarean sections for prevention of surgical site infections. Early removal promoted faster return to daily bath and self care from the patient?s perspective without significantly increasing the chances of infection. However, larger sample size is required to derive a high quality evidence.