Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: a systematic review of reviews and meta‐analyses

Martín, Elizabeth; Beckmann, Michael; Barnsbee, LN; Halton, KA; Merollini, Katharina; Graves, Nicholas

doi:10.1111/1471-0528.15125

Cited by 43 publications

(40 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both Lemming et al and Kawakita et al reported a more than 50% reduction in surgical site infection when either four or nine aspects of cesarean delivery preparation or technique were standardized, respectively. 9 , 10 In a systematic review and meta-analysis of 44 studies, Martin et al 11 found similar surgical site infection reduction when preoperative antibiotic prophylaxis, vaginal preparation and spontaneous removal of the placenta were standardly performed. Carter et al 12 also demonstrated that evidence-based bundles were associated with reduced surgical site infection in a systematic review and meta-analysis.…”

Section: Why Standardize Cesarean Delivery Surgical Technique?mentioning

confidence: 95%

The Case for Standardizing Cesarean Delivery Technique

Dahlke

Mendez‐Figueroa

Maggio

et al. 2020

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

Section: Why Standardize Cesarean Delivery Surgical Technique?mentioning

confidence: 95%

The Case for Standardizing Cesarean Delivery Technique

Dahlke

Mendez‐Figueroa

Maggio

et al. 2020

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…CS wound infection (CS-surgical site infection (SSI): CS-SSI) is a major cause of prolonged hospital stay, high hospital cost, increased morbidity and mortality [3] [4] [5]. Best practices including antibiotic prophylaxis, vaginal preparation, and spontaneous placental removal have been recommended as an infection control [6]. Although the incidence CS-SSIs reported to range from 2% -7% in high-income countries [7], it is not well known in low and middle-income countries [8].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh

Jahan¹,

Begum²,

Islam³

et al. 2019

OJOG

View full text Add to dashboard Cite

Background: Post caesarean section (CS) wound infection or surgical site infection is a leading cause of prolonged hospital stay or readmission. An understanding of its risk factors is important. Methods: A case control study was conducted in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College & Mitford Hospital, in Dhaka, Bangladesh from January to June 2014 to evaluate the risk factors of postoperative surgical site infection following CS. One hundred patients were studied. Results: Fifty patients of post CS wound infection (surgical site infection: SSI) were selected as cases. Body mass index > 25 (kg/m 2), anemia (p = 0.001), prolonged rupture of membrane (p = 0.005), prolonged operation time (p = 0.019), and junior surgeons performing the operation (p = 0.011) were the risk factors for CS-SSI. Conclusions: Pre-and postoperative care and surgical training of junior doctors should be directed to these risk factors.

show abstract

“…6 Consequences of caesarean section SSIs include chronic pelvic pain, delay in returning to normal activities, depression, longer hospital stay and increased hospital costs. 7 Superficial SSIs are much more common than deep or organ/space SSI following caesarean section. At Guy's and St Thomas' Hospital NHS Foundation, superficial SSIs have been significantly reduced through a number of improvement strategies, but deep surgical SSI remained constant.…”

mentioning

confidence: 99%

Implementation of vaginal preparation prior to caesarean section

et al. 2020

View full text Add to dashboard Cite

IntroductionSurgical site infections following caesarean section are associated with significant morbidity. Vaginal preparation is the cleansing of the vaginal epithelium with an antibacterial solution to reduce the bacterial load and therefore reduce ascending genital tract infection. It is recommended by the WHO and a Cochrane review in 2018 concluded that vaginal preparation immediately before caesarean section probably reduces the rates of postoperative endometritis.ObjectiveTo implement vaginal preparation prior to caesarean section at Guy’s and St Thomas’ Hospital NHS Foundation Trust and reduce rates of deep surgical site infections.MethodsThe protocol (included within the appendices) for vaginal preparation prior to caesarean section was developed after reviewing the available evidence. Two vaginal preparation champions, a midwife and a scrub nurse, were selected to help promote and assist in the implementation. The first implementation cycle included elective and category II and III caesarean sections. To ensure acceptability, 20 women were asked to complete a questionnaire following vaginal preparation. Once the intervention was being performed in >85% of eligible women, the inclusion criteria was expanded to include category I caesarean sections.ResultsTwelve months following implementation, vaginal preparation was still being performed in 89% of eligible women. The deep surgical site infection rate is now the lowest recorded in the last 6 years. Vaginal preparation prior to caesarean section was acceptable to pregnant women and no adverse effects were reported.ConclusionsVaginal preparation prior to caesarean section has been successfully implemented at Guy’s and St Thomas’ Hospital NHS Foundation Trust. This simple, cheap intervention, performed with readily available materials, is still being performed in a high number of caesarean sections 12 months post-implementation. It has resulted in a reduction in deep surgical site infections. Involvement of key stakeholders and the recruitment of vaginal preparation champions were key to success.

show abstract

Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: a systematic review of reviews and meta‐analyses

Abstract: Infection control for caesarean: pre-incision AB prophylaxis, vaginal prep, spontaneous placenta removal.

Cited by 43 publications

References 66 publications

The Case for Standardizing Cesarean Delivery Technique

The Case for Standardizing Cesarean Delivery Technique

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh

Implementation of vaginal preparation prior to caesarean section

Contact Info

Product

Resources

About

Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: a systematic review of reviews and meta‐analyses

Abstract: Infection control for caesarean: pre-incision AB prophylaxis, vaginal prep, spontaneous placenta removal.

Cited by 43 publications

References 66 publications

The Case for Standardizing Cesarean Delivery Technique

The Case for Standardizing Cesarean Delivery Technique

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College &amp; Mitford Hospital in Dhaka, Bangladesh

Implementation of vaginal preparation prior to caesarean section

Contact Info

Product

Resources

About

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh