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VOLUME 15 , ISSUE 1 ( January-February, 2023 ) > List of Articles

REVIEW ARTICLE

Insights on Postoperative Infections in Gynecology: A Narrative Review

Purvi Rajendra Thakkar, Ketav Samir Joshi

Keywords : Pelvic pathologies, Prophylactic antibiotics, Surgical site infections, Urinary tract infections

Citation Information : Thakkar PR, Joshi KS. Insights on Postoperative Infections in Gynecology: A Narrative Review. J South Asian Feder Obs Gynae 2023; 15 (1):97-101.

DOI: 10.5005/jp-journals-10006-2198

License: CC BY-NC 4.0

Published Online: 19-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: Postoperative infections in gynecology are common throughout the surgical field. Infections create a major impact on surgeons as well as on patients. With the appropriate use of antibiotics, the chances of infections reduce immensely and prevent morbidity for the same. This review helps to understand the occurrence, preventable risk factors, and complications of postoperative infections with various gynecology surgeries. Background: The literature reviewed in this narrative article is obtained from various databases such as pubMed, Scopus, and Web of Science using medical subject headings (MeSH) compliant keywords such as surgical site infections, wound abscess, pelvic pathologies, and consulting-related books. References from year old to new were assessed and relatable information was included. Review results: Studies included reflect the impact of postoperative infections in various surgeries and the timely use of antibiotics in controlling the outcome. Many factors like gender, duration of hospital stay, and co-morbidities also play a significant roles in the outcome. Conclusion: Studies depict the importance of recognizing the symptoms of the patient, and with the use of appropriate investigations, identifying the pathogens involved in postoperative period; eventually timely use of antibiotics in preventing such cases in the future. These steps shall help in reducing the overall burden for doctors, nurses, and on the patient's side as well. Clinical significance: The most common complications of gynecological surgeries include cellulitis, endometritis, and urinary tract infections (UTI). Early diagnosis and timely use of antibiotics to prevent further complications and morbidity in these patients are of utmost importance. Priority should be given to early detection and identification of risk factors associated with postoperative surgeries. Most of the common pathogens involved awareness regarding the use of antibiotics prophylactically and eventually prevention of postoperative infections under various gynecological surgeries.

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  1. Jaiyeoba O. Postoperative infections in obstetrics and gynecology. Clin Obstet Gynecol 2012;55(4):904–913. DOI: 10.1097/GRF.0b013e3182714734.
  2. Faro C, Faro S. Postoperative pelvic infections. Infect Dis Clin North Am 2008;22(4):653–663. DOI: 10.1016/j.idc.2008.05.005.
  3. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13(10):606–608.
  4. Kolasiński W. Surgical site infections - review of current knowledge, methods of prevention. Pol Przegl Chir 2018;91(4):41–47. DOI: 10.5604/01.3001.0012.7253
  5. No authors listed. ACOG Practice Bulletin No.195: Prevention of infection after gynecologic procedures. Obstet Gynecol. 2018;131(6):e172–e189. DOI: 10.1097/AOG.0000000000002670.
  6. Amenu D, Belachew T, Araya F. Surgical site infection rate and risk factors among obstetric cases of Jimma University Specialized Hospital, Southwest Ethiopia. Ethiop J Health Sci 2011;21(2):91–100. DOI: 10.4314/ejhs.v21i2.69049.
  7. Misganaw D, Linger B, Abesha A. Surgical antibiotic prophylaxis use and surgical site infection pattern in Dessie Referral Hospital, Dessie, Northeast of Ethiopia. Biomed Res Int 2020;2020:1695683. DOI: 10.1155/2020/1695683.
  8. Madeira MZ, Trabasso P. Surgical site infections in women and their association with clinical conditions. Rev Soc Bras Med Trop 2014;47(4):457–461. DOI: 10.1590/0037-8682-0125-2014.
  9. Alkaaki A, Al-Radi OO, Khoja A, et al. Surgical site infection following abdominal surgery: A prospective cohort study. Can J Surg 2019;62(2):111–117. DOI: 10.1503/cjs.004818.
  10. Shahane V, Bhawal S, Lele U. Surgical site infections: A one year prospective study in a tertiary care center. Int J Health Sci (Qassim). 2012;6(1):79–84. DOI: 10.12816/0005976.
  11. Lazenby GB, Soper DE. Prevention, diagnosis, and treatment of gynecologic surgical site infections. Obstet Gynecol Clin North Am 2010;37(3):379–386. DOI: 10.1016/j.ogc.2010.05.001.
  12. Duff P, Park RC. Antiobitic prophylaxis in vaginal hysterectomy: A review. Obstet Gynecol 1980;55(5):193–202. DOI: 10.1097/00006250-198003001-00049.
  13. Duff P. Premature rupture of the membranes in term patients. Semin Perinatol 1996;20(5):401-408. DOI: 10.1016/s0146-0005(96)80007-3.
  14. Jamie W, Duff P. Preventing infections during elective C/S and abdominal hysterectomy. Contemp Obstet Gynecol 2003;1:60–69. Available from: https://www.contemporaryobgyn.net/view/preventing-infections-during-elective-cs-and-abdominal-hysterectomy.
  15. Agostini A, Cravello L, Shojai R, et al. Postoperative infection and surgical hysteroscopy. Fertil Steril 2002;77(4):766–768. DOI: 10.1016/s0015-0282(01)03252-6.
  16. Metgud MC, Kataria A, Nadipally SR, et al. Incidence of wound dehiscence following obstetric and gynecological surgeries at a tertiary care hospital: A retrospective study. J South Asian Feder Obst Gynae 2020;12(2):73–78. DOI:10.5005/jp-journals-10006-1763.
  17. Duff P. The pathophysiology and management of postcesarean endomyometritis. Obstet Gynecol 1986;67:269–274. DOI: 10.1097/00006250-198602000-00021.
  18. Duff P, Gibbs RS, Blanco JD, et al. St. Endometrial culture techniques in puerperal patients. Obstet Gynecol 1983;61(2):217–221. PMID: 6337355.
  19. Falagas ME, Athanasiou S, Iavazzo C, et al. Urinary tract infections after pelvic floor gynecological surgery: Prevalence and effect of antimicrobial prophylaxis. A systematic review. Int Urogynecol J Pelvic Floor Dysfunct 2008;19(8):1165–1172. DOI: 10.1007/s00192-008-0584-0.
  20. Jung CE, Brubaker L. Postoperative urinary tract infection after urogynecologic surgery: Timing and uropathogens. Int Urogynecol J 2020;31(8):1621–1626. DOI: 10.1007/s00192-019-04061-1.
  21. Falagas ME, Velakoulis S, Iavazzo C, et al. Mesh-related infections after pelvic organ prolapse repair surgery. Eur J Obstet Gynecol Reprod Biol 2007;134(2):147–56. DOI: 10.1016/j.ejogrb.2007.02.024.
  22. Duff P. Antibiotic selection in obstetric patients. Infect Dis Clin North Am. 1997;11:1–12. DOI: 10.1016/s0891-5520(05)70338-x.
  23. Duff P. Antibiotic selection in obstetrics: Making cost-effective choices. Clin Obstet Gynecol 2002;45(1):59–72. DOI: 10.1097/00003081-200203000-00008.
  24. Brown CEI, Lowe TE, Cunningham FG, et al. Puerperal pelvic vein thrombophlebitis: Impact on diagnosis and treatment using x-ray computed tomography and magnetic resonance imaging. Obstet Gynecol 1986;68(6):789–795. PMID: 3785791.
  25. Duff P. Prophylactic antibiotics for cesarean delivery: A simple cost-effective strategy for prevention of postoperative morbidity. Am J Obstet Gynecol 1987;157(4 Pt 1):794–798. DOI: 10.1016/s0002-9378(87)80057-1.
  26. Duff P, Gibbs RS. Pelvic vein thrombophlebitis: Diagnostic dilemma and therapeutic challenge. Obstet Gynecol Surv 1983 38(6):365–373. PMID: 6346171.
  27. O'Brien WJ, Gupta K, Itani KMF. Association of postoperative infection with risk of long-term infection and mortality. JAMA Surg 2020;155(1):61–68. DOI: 10.1001/jamasurg.2019.4539.
  28. Vogel TR, Dombrovskiy VY, Carson JL, et al. Postoperative sepsis in the United States. Ann Surg 2010;252(6):1065–1071. DOI: 10.1097/SLA.0b013e3181dcf36e.
  29. Awoke N, Arba A, Girma A. Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia. PLoS One 2019;14(12):e0226140. DOI: 10.1371/journal.pone.0226140.
  30. Suzanne Pear. Patient risk factors and best practices for surgical site infection prevention. Manag Infect Control. 2007:56–64. Available from: 56–64. https://www.halyardhealth.com/wp-content/uploads/patient_risk_factors_best_practices_ssi.pdf
  31. Famakinwa TT, Bello BG, Oyeniran YA, et al. Knowledge and practice of postoperative wound infection prevention among nurses in the surgical unit of a teaching hospital in Nigeria. Int J Appl Sci 2014;3(1):23–28. Available from: https://www.ajol.info/index.php/ijbair/article/view/104690.
  32. Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med 2012;366(11):1028–1037. DOI: 10.1056/NEJMcp1104429.
  33. Flores-Mireles AL, Walker JN, Caparon M, et al. Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol 2015;13(5):269–284. DOI: 10.1038/nrmicro3432.
  34. Zhanel GG, Lawson CD, Adam H, et al. Ceftazidime-avibactam: A novel cephalosporin/β-lactamase inhibitor combination. Drugs 2013;73(2):159–177. DOI: 10.1007/s40265-013-0013-7.
  35. Monahan M, Jowett S, Pinkney T, et al. Surgical site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PLoS One 2020;15(6):e0232960. DOI: 10.1371/journal.pone.0232960.
  36. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017;152(8):784–791. DOI: 10.1001/jamasurg.2017.0904.
  37. Korol E, Johnston K, Waser N, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One 2013;8(12):e83743. DOI: 10.1371/journal.pone.0083743.
  38. Shanbhag ER, Veena P. Surgical Site Infections Following Cesarean Section: A Longitudinal Study. J South Asian Feder Obst Gynae 2021;13(3):77–80. DOI: https://doi.org/10.5005/jp-journals-10006-1889.
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