A Risk-Stratified Peri-Operative Protocol for Reducing Surgical Site Infection after Cesarean Delivery

Talbot, G. Theodore; Maxwell, Rose; Griffiths, Kara M.; Polenakovik, Hari; Galloway, Michael; Yaklic, Jerome L.

doi:10.1089/sur.2019.354

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…In addition, our study participants were evaluated at week-1 and week-2 of post-delivery, whereas in the previously mentioned study, patients were followed up once at day-30 post-delivery. Talbot et al showed that by stratifying patients undergoing cesarean delivery into high-risk and low-risk groups, in which BMI > 30 kg/m 2 was considered as a major risk factor, and managing them according to their risk group (for the low-risk group, a prophylactic dose of pre-operative intravenous antibiotics was assessed, and in the high-risk group, prophylactic antibiotic agents were administrated pre-operatively and continued for 24 h post-operatively) reduced overall SSI rate [ 22 ]. Another randomized trial on 160 participants reported lower post-operative infections, duration of hospitalization, and medication cost by using perioperative metronidazole and cefazolin compared to cefazolin alone [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of postoperative oral administration of cephalexin and metronidazole on surgical site infection among obese women undergoing cesarean section: a randomized, double-blind, placebo-controlled, parallel-group study—phase III

Tara

Danesteh

Rezaee

et al. 2022

Antimicrob Resist Infect Control

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Background Cesarean section (CS) is the most frequently performed surgery in the United States. Compared to vaginal delivery, CS has a higher risk of maternal and neonatal mortality, morbidities, and complications, among which surgical site infection (SSI) is the most common. We aimed at evaluating the effectiveness of postoperative oral administration of cephalexin and metronidazole on SSI among obese women undergoing CS. Methods We conducted a randomized, double-blind clinical trial comparing the prophylactic effect of oral cephalexin and metronidazole vs cephalexin and placebo on SSI following CS among obese women. who had received preoperative prophylactic cephalosporin antibiotics. The study was conducted at the Ommolbanin Hospital, affiliated with Mashhad University of Medical Sciences from April 2019 to February 2020. Result The participants were randomized into the intervention group (n = 210) and the control group (n = 210). At week-1 follow-up, the outcomes were significantly lower in the intervention group as compared to the control group in terms of fever (9% vs 19%, p = 0.003), abnormal discharge from the incision (serous: 8.6% vs 10.5%, purulent: 2.9% vs 16.7%, p < 0.001), incision separation (1% vs 7.1%, p = 0.001), and cellulitis (4.8% vs 13.3%, p = 0.002). At week-2 follow-up, there were no patients in the intervention group with fever, abnormal discharge from the incision, incision separation, or cellulitis and there was a statistically significant difference for fever, abnormal discharge from the incision, and incision separation between the two groups (p < 0.001, p = 0.001, p = 0.014, respectively). Conclusion Post-operative administration of cephalexin and metronidazole for 48-h post-cesarean delivery among obese women, in addition to the standard pre-operative prophylaxis, reduced the overall rate of surgical site infection and wound infection symptoms in a 2-week follow-up. Trial registration The study protocol was approved by the Iranian Registry of Clinical Trials (IRCTID: IRCT20200608047685N2) on 2021-03-15.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of postoperative oral administration of cephalexin and metronidazole on surgical site infection among obese women undergoing cesarean section: a randomized, double-blind, placebo-controlled, parallel-group study—phase III

Tara

Danesteh

Rezaee

et al. 2022

Antimicrob Resist Infect Control

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“…Talbot и соавт. установлено, что стратификация пациентов позволяет не только рационально использовать АБП, но и существенно снизить частоту ВБИ [44]. Так, стратификация риска и протокол для профилактики ИОХВ у женщин, перенесших кесарево сечение, был внедрен в больнице на Среднем Западе.…”

Section: мониторинг и управление антибиотикорезистентностьюunclassified

Nosocomial infections: a look at the problem in the context of the global threat of antibiotic resistance (review)

Perfileva,

Miroshnichenko,

Kulikov

et al. 2024

SJCEM

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Antibiotic resistance poses a serious threat to public health. The problem of nosocomial infections is inextricably linked with antibiotic resistance. Nosocomial infections in most cases are caused by the formation and spread of hospital strains that are resistant to antibacterial drugs. Nosocomial infections caused by multidrug-resistant microorganisms increase healthcare costs, lengthen hospital stays, and lead to extremely poor patient outcomes. The article systematizes data on the prevalence of nosocomial infections and examines the problem of antibiotic resistance of leading nosocomial pathogens. Approaches to monitoring and management of antibiotic resistance and epidemiological surveillance of nosocomial infections are analyzed. A promising area of research in public health is considered – osocomial infections associated with previous hospitalization.

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“…Post-operasi: Pertahankan kadar gula darah ≤200 mg/dl, segera lepas kateter urine maksimal 24 jam kecuali ada indikasi, penggantian POD 2 post post operasi, edukasi pasien tentang perawatan luka post operasi. [5][6][7][8][9][10][11][12][13][14][15][16][17] Dilakukan Pencegahan Infeksi IDO SC dapat dilakukan dengan penerapan bundles of care. Bundles IDO adalah rangkaian sederhana dari praktik berbasis bukti ketika diimplementasikan dapat meningkatkan keandalan dan meningkatkan efektivitas untuk menurunkan infeksi daerah operasi 4 hingga 60 %.…”

Section: Hasilunclassified

Efektifitas Penerapan Bundles IDO Sectio Caesarea: Scoping review

Jubaedah,

Hermayanti,

Erniati

2023

Obgynia

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Tinjauan ini bertujuan untuk mengidentifikasi literatur tentang bundles IDO yang telah terbukti berhasil menurunkan angka kejadian IDO, dapat dijadikan panduan dalam penerapan bundles IDO pada pasien SC Metode: Pencarian dilakukan di beberapa database yaitu PubMed, Scopus dan CINAHL dengan kata kunci yang digunakan yaitu P=Pasien Post-operasi SC OR Cesarean Delivery, Concept=Surgical Site Infections OR SSI, Context=Bundles OR Procedure. Hasil: Delapan belas studi yang melibatkan total 24450. Tiga studi RCT, tujuh Cohort Studi retrospektif, lima Cross Sectional Studi, satu experiment dan dua Case Control studi.Kesimpulan: Bundles IDO terdiri dari Preoperasi: Mandi preoperasi,tidak dilakukan pencukuran rambut,bila mengganggu pakai clipper electrik, pertahankan kadar gula darah ≤200 mg/dl. Intraoperasi: Pemberian Antibiotik, skin dan vaginal preparasi, pertahankan normothermia, kebersihan tangan, penggantian sarung tangan dan set instrument, gunakan jahitan khusus untuk penutupan subkutan dan penutupan kulit. Post operasi: Pertahankan kadar gula darah ≤200 mg/dl, segera lepas kateter urine maksimal 24 jam kecuali ada indikasi, penggantian wound dressing Postoperative day 2, Edukasi Pasien tentang perawatan luka post operasi. Bundles ini dapat menurunkan angka kejadian infeksi IDO pada pasien yang dilakukan operasi SC.

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A Risk-Stratified Peri-Operative Protocol for Reducing Surgical Site Infection after Cesarean Delivery

Cited by 4 publications

References 27 publications

Effectiveness of postoperative oral administration of cephalexin and metronidazole on surgical site infection among obese women undergoing cesarean section: a randomized, double-blind, placebo-controlled, parallel-group study—phase III

Effectiveness of postoperative oral administration of cephalexin and metronidazole on surgical site infection among obese women undergoing cesarean section: a randomized, double-blind, placebo-controlled, parallel-group study—phase III

Nosocomial infections: a look at the problem in the context of the global threat of antibiotic resistance (review)

Efektifitas Penerapan Bundles IDO Sectio Caesarea: Scoping review

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