Pharmaceutical honey in the healing of caesarean section wounds. Prospective cohort study of 766 caesarean sections at Gabriel Toure teaching hospital

Abstract

Objective: the aim of this work is to assess the occurrence of postoperative wall complications with the application of pharmaceutical honey in the healing of cesarean section wounds.

Material and methods: this was a prospective cohort study over a period of 11 months from January 15, 2020 to December 12, 2020 in the department of gynecology and obstetrics of the CHU Gabriel Touré in Bamako. Two groups of patients were included, for group I: all class I and II Altemeir patients who underwent a cesarean section and who accepted the application of pharmaceutical honey (L-Mesitran®) to the operative wound and for group II: all Altemeir class I and II patients who have undergone a cesarean section with a standard surgical wound dressing. The sample was calculated according to Daniel Schwartz's formula and The minimum sample size was 383 patients in each group. Data entry and analysis was done using SPSS software version 22.00. Correlations between variables were sought as appropriate by Pearson's tests, Yates continuity correction and Fisher's exact with a significance level ≤ 5%.

Results: we recorded 18.8% of postoperative complications in group I with 15.4% of infectious complications against 19.3% of postoperative complications in group II with 15.9% of infectious complications. The risk of developing postoperative complications was the same in the two groups 1.0 [0.7-1.3]. These complications were dominated by deep suppurations, superficial suppurations, blackish blood clots and oozing from the skin. The risk of superficial suppurations is multiplied by 49.0 [7.0-345.4] in group I against 15.5 [3.8-62.4] in groups II. We observed a decrease in healing time with the application of pharmaceutical honey.

Conclusion :the application of pharmaceutical honey did not have a great influence on the incidence of surgical site infection but on the other hand considerably reduced the duration of healing of cesarean wounds.