Adapting surgical ‘bundles’ to prevent surgical site infections in obstetrics and gynecology (Review)

Abstract

Surgical site infections (SSIs) are a complication in any surgical field and they are responsible for 38% of surgery-related patient deaths. Identifying appropriate prophylaxis and solutions to combat SSIs is of global interest. Several studies and reports on SSI raise awareness of this costly complication, both in terms of physical and mental suffering, and as a monetary burden. Knowing the risk factors and implementing strategies to reduce SSI risk represent an adequate approach to reduce SSI incidence. General risk factors of SSI are applicable in the obstetrics and gynecology field, alongside its specific characteristics, including immunological changes occurring during pregnancy, as well as disturbances of vaginal microbiota. The risk of SSI is determined by patient factors but also by preoperative, intraoperative and postoperative care. 'Bundle' prevention strategies have been smartly adopted and their efficiency has been demonstrated in colorectal surgery, cesarean deliveries and gynecological oncology surgeries.'Bundle' measures may vary among studies, but they remain important prevention methods, which contribute to decreasing SSIs, which is a favorable outcome, and thus, are increasingly used as a routine practice. Therefore, healthcare personnel should aim for the early identification of risk factors to minimize the risk of SSI. All evidence-based methods for preventing and treating SSIs in all surgical fields should be considered to be integral components in order for the best care to be provided to patients. Contents1. Introduction 2. Risk factors 3. Prevention 4. Surgical 'bundles' 5. Conclusion

High risk factors for massive haemorrhage during medical abortion patients with missed miscarriage

“…For patients experiencing signi cant vaginal bleeding, prompt surgical haemostasis is necessary. Such emergency surgeries, conducted without su cient preoperative preparation, heighten the risk of anaesthetic complications [23] and increase the likelihood of further complications such as infections [24] and organ damage. Patients often endure signi cant pain and suffering from suboptimal experiences during these emergency procedures, causing both physical and psychological distress.…”

Frecuencia de infecciones del sitio quirúrgico en procedimientos ginecológicos y obstétricos.

“…En el año 2022 en nuestro país ocurrieron 644 muertes maternas, donde la séptima causa de mortalidad materna directa fue la sepsis y otras infecciones puerperales [7,8]. De acuerdo con datos de la CDC del año 2022, el 1.4% de las cesáreas y el 2% de las histerectomías realizadas en población estadounidenses resultaron infectadas [9]. Aunque a la fecha no hay cifras exactas sobre la frecuencia de ISQ en pacientes obstétricas y ginecologías en México, un estudio previo del año 2017 reportó una proporción de ISQ del 2.4% para cirugías ginecológicas y del 3.3% para las obstétricas.…”