Serum procalcitonin levels in incisional surgical site infections requiring a secondary suture after cesarean sections

Abstract

Purpose: Surgical site infections (SSIs) after cesarean section cause maternal morbidity and economic and emotional burdens on society. Our aim is to measure procalcitonin (PCT) levels in patients who developed incisional SSIs after cesarean section while also comparing PCT concentrations between patients who underwent a secondary suture and who did not require a secondary suture.

Methods: Ninety-four patients who developed incisional SSI after cesarean section were enrolled in our study. At the time of admission, serum PCT, C-reactive protein (CRP), and white blood cell (WBC) counts were measured. The study population was grouped into two, based on the need of a secondary suture and the patients baseline blood tests were compared.

Results: The mean serum CRP level was not significant among the groups; however, the median serum PCT level was significantly higher in patients who required a secondary suture (0.21 vs. 0.05 ng/ml, p ≤ .0001). Serum PCT levels were positively correlated with the length of hospital stay (r = 0.72, p = .0001). Area under the curve (AUC) for PCT in predicting the need of a secondary suture was 0.85 (95% CI: 0.772–0.922) and the cutoff point was 0.142 ng/ml with a sensitivity of 75% and specificity of 97.8% (p = .0001).

Conclusion: Serum PCT is a promising marker for both diagnosing and predicting the severity of SSIs after cesarean sections.

Keywords:

• Cesarean section
• C-reactive protein
• procalcitonin
• secondary suture
• surgical site infections

Disclosure statement

No potential conflict of interest was reported by the authors.