A PROSPECTIVE COHORT STUDY TO STUDY THE EFFECTIVENESS OF SURGICAL BUNDLE IN REDUCING SURGICAL SITE INFECTION IN CAESAREAN DELIVERIES

OBJECTIVE To study the effectiveness of surgical bundle in reducing Surgical Site Infection following caesarean deliveries.

METHODS: - A prospective cohort study was conducted in the Department of Obstetrics and Gynaecology in Deen Dayal Upadhyay Hospital, New Delhi from April 2021 to June 2022 for and included 620 women undergoing emergency caesarean section. A surgical bundle comprising of: - (i)pre-operative antibiotic prophylaxis- Inj Ceftriaxone 1gm i.v after skin sensitivity testing at the time of skin incision. (ii) Preoperative vaginal cleaning with betadine 5% after Foleys catheterisation and before abdominal scrubbing. (iii) Chlorhexidine - alcohol solution (2.5% chlorhexidine + 70% ethanol) for skin preparation, was tried to be implemented in emergency caesarean deliveries. Patients were divided into two groups on the basis of surgical bundle adherence and implementation. Group 1(n=310; surgical bundle not used) and Group 2 (n=310; surgical bundle used). Data was collected in patient proforma and outcomes were observed for 30 days postoperative period for surgical site infection.

RESULTS: - There was a significant decrease in number of surgical site infections in the group where the surgical bundle was used (all three measures applied). Rates of SSI in surgical bundle not used vs used were 41/310 (13.2%) vs 19/310 (6.1%) respectively with p-value <0.001.

CONCLUSION: - As there is more than 50% reduction in rates of surgical site infection it is concluded that use of a combination of evidence based surgical measures significantly reduce surgical site infection in caesarean deliveries.