Risk of post caesarean wound infection among women managed by open versus closed dressing in Mulago Hospital: A randomised controlled trial.

Abstract

Introduction: Surgical wound infection is the most common maternal complication following caesarean section (CS) worldwide. It accounts for considerable morbidity and mortality, prolonged hospitalization and increased hospital bill. Problem Statement: Post operatively, wound care practices vary greatly among providers. In some places, dressings are removed 24hrs after CS and then left open while in other settings, they are dressed up to the 7th post-operative day (POD). The practice of closed dressings negatively impacts on the available resources especially the nursing personnel and materials. There is need for other alternatives for wound care such as open dressing, however, its associated risk o General Objective: To compare the risk of wound infection among mothers offered open to closed dressing Methodology: An open randomized controlled trial (RCT) was conducted in Mulago Hospital involving mothers who underwent CS. Mothers were recruited at admission, assessed for eligibility, randomized prior to operation and followed up for 7days post operatively. Data was collected using patient enrollment and follow up form. Results: Two hundred six (206) mothers were enrolled, allocated 105 to Open dressing arm and 101 to Closed dressing but 9 were excluded due to post-operative complications and 12 were lost to follow-up. One hundred eighty five (185) mothers completed the study and were included in the analysis. The overall rate of surgical wound infection (SWI) was 7.03%. The rate of SWI among mothers who received Open dressing was 11.22% compared to 2.3% among those who received Closed dressing. Conclusion: Open wound dressing predisposes postoperative mothers to a higher risk of surgical wound infection compared to closed dressing.