Response to ‘Caesarean sections at Royal Darwin Hospital’ letter

Dear Editor,

We would like to thank Dr Harding for her interest and request for additional information regarding our article ‘Surgical site infection following caesarean section at Royal Darwin Hospital, Northern Territory (RDH)’¹. The incidence of surgical site infection (SSI) following caesarean section (c-section) at RDH has continued to decrease. The incidence for the first 6 months of 2012 was 0.9%, a further decrease from our reported post-interventional rate of 3.3%.

Obesity has been described as a risk factor for SSI following c-section (reviewed by Tipton et al.²). In our study, BMI data was frequently absent from the medical chart with BMI recorded on just 16% (3/18) of women with a SSI following c-section, and 44% (89/199) of women without a SSI following c-section. However, all three women with a SSI had a BMI of ≥30, while 30% of women without a SSI had a BMI of ≥30 (P = 0.03).

In our initial scoping study, seniority of the surgeon was examined in 24 infections: eight were performed by staff specialists, 13 were performed by registrars with staff specialist supervision and two were performed by registrars. However, because RDH has a mixture of regular staff specialists, locum specialists and rotating registrars, no surgeon specific factors could be identified.

There are no conflicts of interest associated with this letter. Dr Claire Gordon is partially funded by a Fulbright Scholarship.