Comparing the Effects of Conventional Surgery with Resection of a Layer of Cutaneous and Subcutaneous around the Surgical Incision on Decreasing the Rate of Surgical Wound Infection and Dehiscence in High Risk Patients Operated for Obstetrics and Gynecologic Conditions

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Women’s Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Resident of Obstetrics and Gynecology, Women’s Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: Surgical wound infection is a bacterial infection in surgical site that cause problem in 1.2 to 7.1% of surgeries and 3 to 15% of cesarean deliveries. Different ways have been recommended to prevent infection in obstetrics and gynecologic surgeries such as prescribing prophylactic antibiotics and applying correct operation techniques. The aim of this study was comparing the effect of excising of a layer of cutaneous and subcutaneous during abdominal wall closing after surgeries on reducing wound infection.
Methods: This randomized clinical trial was carried out in Taleghai and Alzahra hospitals, Tabriz, Iran during 2012 on 740 gynecologic operation candidates who were high risk of wound infection. Cases were divided into two groups. In first group closing incision site was performed traditionally and in second group a layer of cutaneous and subcutaneous all around incision site was resected. Clinical findings of wound infection during 10 days after operation was studied and two groups were compared. Data were analyzed using SPSS software version 17, t-test, chi-square and Exact Fisher tests. P value less than 0.05 was considered significant.
Results:The differences between both control and intervention groups were not statistically significant regarding age, weight, height and distribution of wound infection factors (p>0.05). 28 cases (7.4%) in intervention group and 45 women (12.1%) in control group had wound infection, that the difference was statistically significant (p=0.04). Among risk factors of wound infection, intervention only made a significant statistical reduction in wound infection in obese patients in relation to control group (p<0.05).
Conclusion: Resection of a layer of cutaneous and subcutaneous during abdominal wall closing after obstetrics and gynecologic surgeries can decrease wound infection especially in obese patients.
 

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