ABU DHABI // Hospitals have been urged to improve protection for patients from infections after surgery.
Mothers whose babies are delivered by Caesarean section, one of the most common surgical procedures, are at particular risk of “surgical site infections” – which affect the part of the body that was operated on.
Procedures need to be established to minimise the risk for patients as they recover from an operation, said Dr Nellie Boma, chief medical officer at Al Rahba Hospital in Abu Dhabi.
“No patient should come to a hospital and fall ill, or worse, die,” she said.
“In my opinion, surgical site infections in Caesareans are the most frequent cause for women to contract infections in the operating room. To prevent or limit infection after the operation, strict infection control policies must be implemented.”
Caesareans, or C-sections, are classified as high-risk operations, but The National reported this year that many women were opting for surgery over natural delivery because they feared the pain of childbirth. One Dubai hospital said C-section rates were almost double the global recommended figure.
Surgical site infections after C-sections can significantly prolong hospital stays or even increase morbidity rates, said Mohamed Hamad, infections control manager at the hospital management company VPS Healthcare.
“A woman who has had a Caesarean should be able to go home in a week, but if they get an infection they might have to stay there for a month,” he said.
“Also, the longer they stay at the hospital the more they are exposed to infections.”
Surgical site infections are preventable, he said, but there were several factors to keep in mind.
“Before operating on a patient, it is important to use a hand scrub properly and for at least three to five minutes. If the proper technique is not used, it can be dangerous for the patient.
“Ideally, a patient should be admitted to the hospital on the day of the operation or the day before it, to reduce their exposure to infections.”
He said the operating theatre should be divided into different zones, such as a clean zone, sterile zone and disposal zone, to prevent bacteria spreading. The patient should be operated on only in the sterile zone.
He said maintaining temperature and humidity were vitally important.
“Also, for hair removal, creams or clippers should be used instead of razors,” said Mr Hamad. “Though these practices are the norm in many hospitals, any neglect or ignoring these concerns has an adverse effect on the patient.”
Another system is the “bundle of care” approach, which entails monitoring the temperature or blood-sugar level of a patient, providing prescribed antibiotics at the right time and other measures.
“We are working on a new model in which we are trying to educate the patients so that they can look after themselves once they go home after the operation. Within two to three days after the operation, we invite the patients for post-discharge outreach call, when we ask them questions about how they maintain hygiene,” said Dr Boma.
“This is also an opportunity to give them educational material on taking care of their dressing.
“Patients should also take care of their hygiene. Often, we have people coming for operations without bathing or shaving,” said Mr Hamad.
Dr Boma will be speaking about the prevention of surgical site infection at a conference in Dubai next month.
arizvi2@thenational.ae
