Infectious complications following abdominal hysterectomy in Karachi, Pakistan

OBJECTIVE: In this paper we studied the prevalence of post-operative infections after total abdominal hysterectomy in Karachi, Pakistan and their associated risk factors. METHOD: A retrospective analysis was conducted by reviewing the case notes of 827 consecutive total abdominal hysterectomies. RESULTS: The post-operative infection rate was 22%. Of the patients, 6% (49) developed operative site infections including wound and vaginal cuff infections and pelvic abscesses while 16% (133) developed non-operative site infections including urinary tract infections and thrombophlebitis. Six risk factors were found to be significantly associated with post-operative infections: a pre-operative hospitalization of more than 2 days (P<0.02); additional non-gynecological procedures performed intra-operatively (P<0.02); indwelling catheterization for more than 7 days (P<0.001); patient's age greater than 50 years (P<0.02); an underlying malignancy (P<0.0001); and developing a hematoma post-operatively (P<0.04). CONCLUSION: The results of this study may serve as a baseline for future comparison and indicate interventions which may contribute to a reduction in the post-operative infection rate.