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Original Papers

Comparison of surgical site infections and patients’ comfort level with caesarean section wounds following early exposure versus delayed exposure

Authors:

M. D. Chandrasiri ,

Teaching Hospital, Kandy, LK
About M. D.
Senior Registrar
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R. C. Fernandopullae

University of Sri Jayewardenepura, LK
About R. C.
Senior Lecturer, Department of Obstetrics & Gynaecology Faculty of Medical Sciences
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Abstract

Introduction: In the prevention of surgical site infections (SSIs), the ideal timing for removal of dressing remains unresolved.

Objectives: To determine the outcomes of early removal of wound dressing in terms of surgical site infections (SSI), patients’ comfort level and whether it was acceptable to the patients

Methods: The study was conducted at the Obstetric Unit of the Professorial Unit of Colombo South Teaching Hospital from September 2012 to February 2013.Out of 498 patients assessed for eligibility, 400 were randomised using a stratified [emergency versus elective caesarean sections (CS)] design into the intervention and control groups. There were 281 and 119 patients in the emergency CS and elective CS groups respectively. In the total sample, 205 patients underwent the intervention (removal of dressing between six and 12 hours after CS) and 195 patients underwent delayed wound exposure between 24 to 30 hours after CS (controls). Patients were reviewed before discharge and in two weeks. On the 1st post-operative day, using a visual analogue scale, their ability to sit up, get off the bed, walk and squat was assessed. The acceptability of early wound exposure was assessed in the intervention group with a structured closed ended questionnaire administered on the 1st post-operative day.

Results: There was no significant difference in the SSI rates between the two groups, in both strata. Patients in the intervention group were able to perform all the given tasks more easily than in the control group (p < 0.001). Of the 183 respondents in the intervention group, 85% would prefer to have the wound dressings removed early for their next CS, 78% thought early removal of dressing improved their hygiene and 90% thought it improved their overall comfort.

Conclusion: Clean, primarily sutured CS wounds ,exposed within six to 12 hours after surgery do not have an increased incidence of SSI compared to those that are exposed within 24 to 36 hours. The patients were more comfortable and better able to carry out simple tasks after early exposure compared to delayed exposure, and early exposure was well accepted by the majority of patients who had this intervention.

How to Cite: Chandrasiri, M.D. & Fernandopullae, R.C., (2016). Comparison of surgical site infections and patients’ comfort level with caesarean section wounds following early exposure versus delayed exposure. Sri Lanka Journal of Obstetrics and Gynaecology. 38(1), pp.4–11. DOI: http://doi.org/10.4038/sljog.v38i1.7784
Published on 19 Aug 2016.
Peer Reviewed

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