Proposal for Modification and Clinical Adaptation of the ASEPSIS Wound Scoring System

A bstract Background: The ASEPSIS wound score was developed to assess post-operative wound infections for use in clinical trials of antibiotic prophylaxis. It is an acronym representing the need for “Additional treatment, presence of Serous discharge, Erythema, Purulent discharge, Separation of deep tissues, Isolation of bacteria, and the duration of in-patient Stay.” It is a wound scoring system that uses the quantitative method of wound assessment to determine the quality of wound healing. It is very valuable but has some limitations. The aim of the study was to modify the scoring system to address the limitations that have been observed. Materials and Methods: This is a prospective longitudinal study on the outcome of post-Cesarean section wounds. The ASEPSIS wound score was modified with the addition of superficial separation of tissues, which was assigned half the numerical value of deep separation of tissues; “secondary surgical wound closure” added to the additional treatment; and wound inspection on two post-operative days for the collection of data. Results: A total of 132 pregnant women underwent delivery. There were 47 (35.6%) patients with varying percentages of wound separation. Forty-two (31.8%) patients had superficial wound separation, while five (3.8%) patients had deep separation. Wound dehiscence significantly influenced the modified ASEPSIS score (<0.001). There was a significantly prolonged hospital stay among patients with surgical wound dehiscence (<0.0001). Two patients required wound debridement and secondary surgical wound closure. Conclusion: The ASEPSIS wound scoring system is a valuable tool in the assessment of post-operative wounds. However, it has some limitations, prompting the modifications we thus proposed.