A retrospective study of surgical site infections post caesarean section in a secondary care hospital

Background: Surgical site infection (SSI) is an important healthcare-associated complication following caesarean section and may result in maternal morbidity, prolonged hospital stay, increased healthcare expenditure, and delayed wound healing. Identification of associated risk factors and strengthening preventive practices are essential, particularly in secondary-care settings. Aim was to determine the frequency, pattern, and associated patient-related risk factors of SSI following caesarean section and to identify measures that may contribute to improved infection prevention and postoperative care. Methods: A retrospective study was conducted at a secondary-care health facility from April 2020 to March 2024. Hospital records of women who underwent caesarean section and subsequently developed SSI were reviewed. Available demographic, obstetric, surgical, and postoperative data, including wound-related complications and management up to 6 weeks after surgery, were analysed. Results: During the four-year study period, 4,948 caesarean sections were performed, of which 519 (10.4%) were complicated by SSI. Among women with SSI, 122 (23.5%) had superficial wound infections, while 397 (76.4%) developed severe wound gaping requiring re-suturing. The most frequently identified risk factors were obesity (28%), anaemia (24%), and a history of previous surgery (22%), followed by personal hygiene-related factors (14%) and other or unspecified factors (12%). The annual number of caesarean sections increased progressively from 935 to 1,426, whereas the SSI rate declined from 8.1% in 2020-2021 to 6.8% in 2023-2024. Conclusions: SSI remains a significant postoperative complication following caesarean section, with obesity, anaemia, and previous surgery being prominent associated factors. The decline in SSI rates despite increasing caesarean volumes underscores the potential value of strengthened infection-prevention practices and postoperative surveillance. Early identification of high-risk women, adherence to aseptic surgical practices, appropriate perioperative care, and timely management of wound complications may reduce SSI-related morbidity and improve the quality of obstetric surgical care.