74: Alexis O-ring wound retractor for the prevention of post-cesarean surgical site infections: a randomized controlled trial

Nakad, Ramzy; Dunn, Holly E.; Olson, Gayle; Poole, Aaron; Fox, Karin A.; Saade, George R.

doi:10.1016/j.ajog.2014.10.120

Cited by 2 publications

(3 citation statements)

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“…One of these is a study conducted in the United States that confirmed there was no significant difference in SSIs with the use of the Alexis ® in women undergoing caesarean delivery at term. 14 The study included 536 patients and did not find any difference in time to delivery, total operative time, estimated blood loss or postoperative pain. 14 In another study conducted among obese pregnant women undergoing CS, the use of the Alexis ® retractor did not decrease the incidence of postcaesarean SSI among a population of obese pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…14 The study included 536 patients and did not find any difference in time to delivery, total operative time, estimated blood loss or postoperative pain. 14 In another study conducted among obese pregnant women undergoing CS, the use of the Alexis ® retractor did not decrease the incidence of postcaesarean SSI among a population of obese pregnant women. 15 Furthermore, in another prospective study of more than 230 women in which the Alexis ® plastic sheath retractor and Doyen's retractor were compared together, no evidence of SSI was reported, as defined in terms of wound dehiscence, pain or tenderness in the lower abdomen, localised swelling, redness, heat or purulent discharge from the wound in any of the participants.…”

Section: Discussionmentioning

confidence: 99%

“…13 The device has been used to provide adequate and atraumatic wound retraction during surgery, together with its ability to reduce postsurgical infections, particularly during gastrointestinal surgeries. 13,14,15,16,17,18,19 The environmental impact of producing the Alexis ® retractors has to be balanced with the benefits derived from its clinical use in the long term.…”

Section: Introductionmentioning

confidence: 99%

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Alexis O-ring wound retractor versus traditional metal retractors for the prevention of postcaesarean surgical site infections

Mothiba

Tshepuwane²,

Adefolalu³

et al. 2023

S Afr Fam Pract

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Background: Postcaesarean surgical site infections (SSI) remain a burden globally. The Alexis® O C-Section Retractor, a plastic sheath retractor known to have decreased incidence of SSIs in gastrointestinal surgery, is yet to have its efficacy established during caesarean section (CS). This study aimed to compare the differences in the rate of postcaesarean surgical wound site infections between the Alexis® retractor and traditional metal retractors during CS at a large tertiary hospital in Pretoria.Methods: Pregnant women scheduled for elective CS were prospectively randomised to either the Alexis® retractor group or the traditional metal retractor group at a tertiary hospital in Pretoria between August 2015 and July 2016. The defined primary outcome was development of SSI, and secondary outcomes comprised patients’ peri-operative parameters. All participants’ wound sites were observed in the hospital for 3 days before discharge and again at 30 days postpartum. Data were analysed using SPSS version 25 with p 0.05 considered significant.Results: A total of 207 participants were involved, Alexis® (n = 102) and metal retractors (n = 105). None of the participants developed postsurgical site wound infection after 30 days, and there were no differences in time to delivery, total operative time, estimated blood loss or postoperative pain between the two arms of study.Conclusion: The study found no difference in participants’ outcomes using the Alexis® retractor in comparison with the traditional metal wound retractors. We suggest that the use of Alexis® retractor be at the surgeon’s discretion and its routine use not advised for now.Contribution: This research being the first of its kind in South Africa in which patients’ clinical outcomes were compared post caesarean section from Alexis’s plastic sheath group and metal retractors group in an attempt to proffer solution to the high burden of SSI. Although no difference was seen at this point, the research was pragmatic, as it was carried out in a setting with high burden of SSI. The study is going to serve as a baseline against which studies carried out in future can be compared.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%