Abstract:
Surgical site infection refers to an infection that occurs at or near a surgical incision
site within 30 days post operation. Caesarean section is one of the most performed
surgical procedures carried out in obstetrics and constitutes about 15% of all
deliveries globally, with Latin America being the highest at 29.2%. The study aimed
to assess the determinants of surgical site infection following caesarean section
among women at Thika level 5 hospital. The study design was a mixed unmatched
case-control study which followed women who had undergone caesarean section in
maternity unit at Thika Level 5 Hospital and who had or did not have surgical site
infection from delivery up to two weeks post-delivery and nurse in-charges of
maternity unit. The researcher adopted a census technique to sample clients who
came for review at maternal child health clinic at 14th day post caesarean section.
Study participants who met the inclusion criteria were recruited into the study as they
sought the routine clinical care services in the clinic. Purposive sampling was used
for the nurse in charges in maternity unit and maternal child health clinic. They
provided qualitative data for the study. The findings revealed that factors associated
with surgical site infections among post caesarean section women at Thika Level 5
Hospital were; age, duration of labor, duration of ruptured membrane and indication
of CS. Women who were aged more than 35 years were 3.82 times more likely to
have surgical site infections compared to those who were aged less than 35 years
[3.82 95%CI=2.67 – 11.21, p=0.007]. Women who had labor more than 8 hours were
3.12 times more likely to have surgical site infections compared to those who had
labor for a period of 4 to 8 hours [OR=3.12; 95%CI=1.88 – 8.28, p=0.003]. Also,
women who experienced rupture of the membrane for more than 24 hours were 3.85
times more likely to have surgical site infections compared to women that
experienced membrane rapture for 24 hours or less [OR=3.85; 95%CI=2.81 – 12.03,
p=0.010]. Furthermore, women who experienced prolonged labor were 6.19 times
more likely to have surgical site infections compared to women who did not have
prolonged labor [OR=6.19; 95%CI=3.11 – 9.54, p=0.009]. Management of Thika
Level 5 Hospital should pay a close attention to the maternal, labor and health
systems related factors that are likely to cause surgical site infections among post
caesarean section women admitted in the facility. Also, a continuous education
program for healthcare workers and young new women is necessary and can be
feasible and potentially successful, given the interest expressed by healthcare
workers in the management of surgical site infections.
