A Study of incidence of Hospital acquired infection in oral and maxillofacial surgery ward
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
AIMS: The aim of this study is to determine the incidence, various risk factors, various methods of diagnosing infection, disinfection and sterilization methods, efficacy, degree of microbial contamination, severity of wound infection by clinical grading of post operative wound infection in the department of oral and maxillofacial surgery at Acharya Vinoba Bhave rural hospital attached to Jawaharlal Nehru medical college and Sharad Pawar dental college, sawangi (Meghe) Wardha in collaboration with department of Microbiology of the same institute. MATERIALS AND METHODS: The present study is an Prospective. A total of 414 patients were subjected to various surgical procedures. Out of 361 cases either it was day-care surgeries or patient discharged on or before first pre-owned operative day. Remaining 261 patients were included in the study and cases were classified by degree of surgical site contamination based on the criteria laid down by National Research Council of USA. Patient with remote infection were not included. All surgeries were performed in the operation theatre site was prepared with 2 % savlon followed by tincture of iodine and spirit. Infected were kept dressed in dressing room whereas clean cases were kept dressed at bedside. Wounds were examined on regular basis on 2 nd , 4 th, 6th, 10th post-operative day to check for wound infection evidence. Wounds infection was clinically graded as grade-I (serous/serosanginous), grade-II (Frankly purulent discharge) and grade-III (purulent discharge). 261 cases were studied to determine the post-operative wound infection with other parameters like fever, urinary tract, blood stream and lower respiratory tract infection. Blood sample was taken for culture and sensitivity from all the patients with pyrexia. Patient with oro-facial space infection were also admitted. Antibiotic sensitivity test was done employing modified stroke method using standard NCTC strains as controls. Ward environment and operation theatre environment was studied by sending swabs for culture from different sites of the ward and theatre e.g. Roof wall, dressing trolley, sister’s and surgeon’s hand. RESULTS: 261 patients were included in the study out of 441 patients. Overall incidence of post-operative wound infection was 23.3 %. CONCLUSION: The wound sepsis still remains the most dreaded complication of a surgical operation. 1 Significant determinants were type of operation, distribution of clinical grades, urgency of operation, use of drain, age of patient, sex of the patient, surgery with various predisposing factors, duration of pre-operative hospital stay, total duration of operation, use of electrocautery, antimicrobial prophylaxis, wound infection and post-operative hospital stay, pyrexia and post-operative infection, mortality rate due to post-operative wound infection.2,3 The future advances will help to change the antibiotics strains of bacteria and increased the efficacy of antibiotics.
Authors and Affiliations
Dr. Kanishka N Guru, Dr. Rashmi Guru, Dr. Kapil Malviya, Dr. Rajiv Borle
Keywords
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- EP ID EP557262
- DOI 10.9790/0853-1803126574.
- Views 48
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