Incidence and risk factors for wound disruption following cesarean section

  Introduction: Cesarean section is one of the most commonly performed surgical procedures in hospitals. The rates of surgical site infection after cesarean section reported in the literature range from 3% to 15 %. The aim of this study was to identify incidence and risk factors of wound disruption following cesarean delivery.   Materials and Methods : A retrospective multistage study in two phases (the first stage a historical cohort and the second stage a case control) was carried out over a 6 year period from 21st March 2002 to 20th Feb 2008 in Mahdieh Tertiary Care Hospital. In the first stage, we identified wound disruption cases with using wound complication code in all cesarean sections were performed during this period. In the second phase of the study, risk factors associated with the wound disruption after cesarean section were evaluated and for each case two controls were selected. These controls were non complicated cesarean section patients just before and after each disrupted cesarean wound.   Results : A total 10525 women who underwent cesarean section during this period, 48 (0.4%) were complicated by wound disruption. Using a multivariable logistic regression model, the following risk factors were identified: diabetes (P=0.02, OR: 5.46 95%CI: 1.02-49.2), hypertension disorders(P=0.001 OR: 5 95%CI: 1.7-14.3), emergency cesarean delivery (P=0.01 OR: 3.3 95%CI: 1.2-9.4), post cesarean fever (P=0.0001 OR: 16.2 95% CI: 4.4-59), and post cesarean laparatomy (P=0.013, OR: 6.3 95%CI: 6.3-62).   Conclusion: Identification of the predictable risk factors for wound disruption and control of these factors may lead to decrease of wound disruption after cesarean section.