Prevalence of Surgical Site Infections Among Cesarean Section Patients at a Tertiary Care Hospital in Faisalabad: A Comparative Study of Care Bundle vs. Standard Care
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Abstract
Background: Surgical site infection after cesarean section is a major contributor to preventable maternal morbidity, particularly in resource-constrained obstetric settings where emergency surgery, variable infection-prevention practices, and affordability barriers may affect postoperative outcomes. Objective: To estimate the prevalence of surgical site infection among cesarean-section patients at a tertiary-care hospital in Faisalabad and compare observed infection rates between patients receiving a structured perioperative care bundle and those receiving standard care. Methods: This prospective non-randomized comparative study was conducted at Mujahid Hospital, Faisalabad, from October 2025 to February 2026. A total of 300 women undergoing cesarean section were included: 150 received a complete care bundle and 150 received standard care, comprising 100 emergency cesarean-section patients and 50 non-affording elective patients. The bundle included antiseptic skin preparation, pre-incision cefazolin prophylaxis, vaginal preparation, sterile draping and instrument handling, suture wound closure, and structured postoperative wound review. Surgical site infection was assessed within 30 days. Categorical data were analyzed using frequencies, percentages, and chi-square testing. Results: Overall surgical site infection prevalence was 12.33% (37/300). No infections occurred in the care bundle group, while 37 infections occurred in standard-care controls, giving a control-group infection rate of 24.67% (p < 0.001). Emergency controls accounted for 25 infections and non-affording elective controls for 12 infections. Month-wise SSI rates declined from 18.67% in October and 20.00% in November to 0.00% in February (χ² = 13.38, df = 4, p = 0.010), although calendar time and exposure category may have been confounded. Conclusion: Complete care bundle receipt was associated with no observed surgical site infections, whereas standard-care patients had a substantial infection burden. Wider bundle coverage may improve post-cesarean infection prevention, but non-randomized allocation and lack of baseline risk adjustment require cautious interpretation
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