Infections after hysterectomy a prospective nation‐wide Swedish study

Persson, Elisabeth; Bergström, Mats; Larsson, Per-Gunnar; Moberg, Peter; Platz-Christensen, Jens-Jörgen; Schedvins, Kjell; Wølner‐Hanssen, Pål

doi:10.3109/00016349609065742

Cited by 52 publications

(27 citation statements)

References 8 publications

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“…UTI as a cause of fever morbidity is reported by authors Anand, Juha, Antoneille, Person E and Karthika1. 3,4,5,9,10 Prolonged surgery time with increased bleeding was seen in 41 women (36%). Table 5 shows follow-up morbidity at 4 weeks.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

“…Pelvic fluid collection assessment, by USG was done in women with vault hematoma and vault cuff infection. 5,[8][9][10] Follow-up morbidity was assessed at 4 weeks post operatively. Local examination of abdominal wound and vault inspection was done in all cases who came for follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…10 Larson, Person, and Karthika have also reported bacterial vaginosis in vaginal cuff infections. [8][9][10] Bacterial vaginosis is one of the important risk factors in post hysterectomy morbidity. Staphylococcus was the commonest organism seen in wound and vault infection in the present series which corresponds to Karthika's observation.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

“…[1][2][3][4]7,9 41 women had more than 10 days stay in our hospital. UTI as a cause of fever morbidity is reported by authors Anand, Juha, Antoneille, Person E and Karthika1.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

“…[8][9][10][11] Risk factors for delayed morbidity and prolonged hospital stay were, wound sepsis with induration in 13 and gaping due to sub-fascial hematoma which needed re-suturing in 71 cases respectively. 4,7,9 Urinary infection was seen in 24 cases. Commonest was E. coli.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

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Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India

Lakshmi

Sheela

Munusamy

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hysterectomy is the removal of uterus for benign uterine tumor and uterine descent in perimenopausal women. Post hysterectomy and follow up morbidity in rural women is studied over a period of 1 year. They were reviewed during hospital stay to identify morbidity and risk factors for prolonged hospital stay and formulate modalities to reduce morbidity. Risk factors assessed were fever, wound sepsis, anemia, previous post-operative adhesions and injury to other organs. Follow up was done at 4 weeks. 72% women were morbidity free. 46% women had more than one morbidity. The aim of this study is to analyse immediate and late post hysterectomy morbidity in a rural setup and to identify risk factors for prolonged hospitalization and formulate modalities to reduce morbidity and duration of hospital stay. Method: Perimenopausal women who underwent hysterectomy for benign uterine conditions and uterine descent were studied for post-operative morbidity at SSSMCRI over a period of one year. Post hysterectomy morbidity was clinically assessed from day one of surgery till discharge, for early and late morbidity. Abdominal skin incision smear, vault smear, urine culture and USG pelvis for collection of fluid was done in woman who developed fever. Follow-up morbidity was done at 4 weeks. Hysterectomy done for malignant conditions were excluded from the study. Results: In rural women, postoperative morbidity was assessed in 81 abdominal, 32 vaginal hysterectomy. Postoperative pain was felt by all 113 women for first 3 days. Fall of hemoglobin due to haemorrhage was seen in 43 (38%) women. 33 needed post-operative blood transfusion. Surgical site infection was seen in 13, needed re-suturing in 7. Fever was seen in 50 women (44%) due to UTI (E coli 13, Klebsiella 5). Pelvic fluid collection was seen in 9 with vault infection. We had one burst abdomen, one re-laparotomy, 3 bladder injuries. Prolonged hospital stay was seen in 41 women. 46% had more than one morbidity. Follow-up at 4 weeks, 72% were morbidity-free. Prolene granuloma 2, Stitch abscess 9, vaginal discharge 14, vault granuloma 3 were observed. Vaginal smear showed 9 Staphylococcus aureus and 5 bacterial vaginosis infection. 12 women had E. coli and 6 Klebsiella infection in urine culture. Conclusion: Pre-operative risk factors for post op morbidity like anemia, urinary and vaginal infection should be properly treated prior to surgery. Awareness of risk factors for morbidity, anticipation of complications due to size, site, nature of tumour and previous surgery adhesions, timely intervention by experienced surgeons and adequate blood transfusion will reduce morbidity and prolonged hospital stay.

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Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

“…[1][2][3][4]7,9 41 women had more than 10 days stay in our hospital. UTI as a cause of fever morbidity is reported by authors Anand, Juha, Antoneille, Person E and Karthika1.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

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Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India

Lakshmi

Sheela

Munusamy

2017

Int J Reprod Contracept Obstet Gynecol

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The role of bacterial vaginosis in infection after major gynecologic surgery

Lin

Song

Kimber

et al. 1999

Infect. Dis. Obstet. Gynecol.

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PURPOSE: Previous studies have reported an association between bacterial vaginosis (BV) and postoperative fever and infection. This prospective study investigated whether the intermediate or definite stages of BV are risk factors for postoperative infection after major gynecologic surgery. METHODS: Vaginal cultures were obtained preoperatively from 175 women undergoing gynecologic surgery. The diagnostic criteria for BV were based on Nugent's standardized method of Gram stain interpretation. Postoperative fever was defined as at least one temperature equal to 101.0 degrees F or greater, or two or more temperatures more than 6 hours apart equal to 100.4 degrees F or greater. RESULTS: Thirty-six percent of the positive-BV group developed a postoperative fever, compared with 20% of the Lactobacillus-predominant group and 12% of the intermediate-BV group (P = 0.017). The differences between the positive-BV group and the Lactobacillus-predominant group, and between the positive-BV group and the intermediate-BV group, with respect to postoperative fever, were statistically significant (P = 0.045 and P = 0.007, respectively). The difference between the intermediate-BV group and the Lactobacillus-predominant group was not statistically significant (P = 0.28). CONCLUSIONS: Although the association between BV and postoperative febrile morbidity could be a spurious result of confounding with other variables, it may be prudent for the surgeon to identify patients with BV and treat them preoperatively.

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Bacterial Infections of the Genital Tract

Ison¹

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Infections after hysterectomy a prospective nation‐wide Swedish study

Abstract: The postoperative infection rate after hysterectomy was clinically significant in this population. Wertheim-Meigs procedures, peroperative bleeding > 1000 ml and BV were identified as risk factors for postoperative infections after hysterectomy.

Cited by 52 publications

References 8 publications

Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India

Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India

The role of bacterial vaginosis in infection after major gynecologic surgery

Bacterial Infections of the Genital Tract

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