Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Vallejo, Manuel C.; Attaallah, Ahmed F.; Shapiro, Robert E.; Elzamzamy, Osama M; Mueller, Michael; Eller, Warren S.

doi:10.1007/s00540-016-2266-2

Cited by 19 publications

(21 citation statements)

References 27 publications

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“…Our findings are in accordance with risk factors known to be adversely associated with healing following surgical interventions, such as obesity, urgent CD, and chorioamnionitis 3,8. However, they partly differ from those of Vallejo et al,24 who found that high BMI, low education, parity, tobacco use, hypertension, urgent CD, and GDM were risk factors for wound infection, while PPROM was protective. The presence of PPROM was positively associated with the development of wound healing problems, while diabetes was not, although it is known to be a risk factor for the development of surgicalF I G U R E 2 Rates of wound healing problems 6 wk following CD in the context of various obstetric complications.…”

supporting

confidence: 88%

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

Heinemann

Solnica

Abdelkader

et al. 2019

Intl J Gynecology & Obste

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Objective To investigate optimal timing of dressing and staples removal after cesarean delivery (CD). Methods This prospective clustered clinical trial enrolled women undergoing CD between January 1, 2013, and October 31, 2014, at Hadassah–Hebrew University Hospital, Jerusalem. Women were assigned to one of five clusters differing in timing of dressing and staples removal. We assessed scar healing at 6 weeks. Results 920 women completed telephone questionnaires. Wound healing did not differ significantly among the clusters: the healing complication rate was 21% in the control group (n=46) and ranged from 18% to 26% (n=27–50) in clusters two to five (P=0.49). More healing complications were observed in women with a body mass index (BMI) of more than 35 kg/m2 versus 35 kg/m2 or less (P=0.016), urgent versus elective CD (P=0.013), preterm premature rupture of the membranes (PPROM) versus intact membranes (P=0.016), and chorioamnionitis at delivery versus no chorioamnionitis (P=0.001). 586 (64%) women underwent physician assessment at staples removal and at 6 weeks post CD. Conclusions Timing of dressing and staples removal has no effect on CD scar healing in low‐ and high‐risk parturients. A BMI of more than 35 kg/m2, urgent CD, PPROM, and chorioamnionitis were associated with mal‐healing, regardless of cluster. Clinicaltrials.gov: NCT01724255.

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supporting

confidence: 88%

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

Heinemann

Solnica

Abdelkader

et al. 2019

Intl J Gynecology & Obste

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“…Pre-operative conditions such as prolonged labor, prolonged rupture of membrane (PROM), more than 5 digital vaginal examination, chorio-amnionitis, American society of Anesthesiologist (ASA) health status classification ≥3, fewer years of education, higher prior births, prior diagnosis of hypertension and Diabetes Mellitus (DM) were identified as significant factors for SSI following CDs [10, 15, 16, 19–22]. Similarly intra operative conditions like prolonged duration of surgery, wound contamination class III, vertical skin incision and interrupted skin suturing were associated factors for developing SSI [8, 9, 15, 16, 19, 23, 24]. CD for emergency conditions like non-reassuring fetal heart rate pattern (NRFHRP) was also significantly associated factor for developing SSI [19, 24, 25].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly intra operative conditions like prolonged duration of surgery, wound contamination class III, vertical skin incision and interrupted skin suturing were associated factors for developing SSI [8, 9, 15, 16, 19, 23, 24]. CD for emergency conditions like non-reassuring fetal heart rate pattern (NRFHRP) was also significantly associated factor for developing SSI [19, 24, 25]. In addition, Postoperative anemia was also found to be a post-operative factor associated with SSI [16, 26].…”

Section: Introductionmentioning

confidence: 99%

Surgical site infection and associated factors among women underwent cesarean delivery in Debretabor General Hospital, Northwest Ethiopia: hospital based cross sectional study

Molla

Temesgen

Seyoum

et al. 2019

BMC Pregnancy Childbirth

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Background Cesarean section rates have been increasing dramatically during the past three decades and surgical site infections are becoming a leading cause of morbidity and mortality among women undergoing cesarean deliveries. However there is lack of sound evidence on both the magnitude of the problem and the associated factors in developing countries including Ethiopia. The purpose of this study was to assess proportion of surgical site infection and associated factors among women undergoing cesarean delivery in Debretabor General Hospital. Methods An institution based cross sectional study was conducted from May to December / 2017. All women delivered by cesarean section in Debretabor General Hospital during data collection period were our study population. Data were collected using Pre-tested, semi-structured questionnaire/ data extraction tool and post discharge phone follow up and analyzed using SPSS version 20. Logistic regression model was used to determine the association of independent variables with the outcome variable and odds ratios with 95% confidence interval were used to estimate the strength of the association. Results Proportion of surgical site infection among cesarean deliveries was about 8% (95%Cl: 5.4, 11.6). Pregnancy induced hypertension (AOR = 4.75, 95%CI: 1.62, 13.92), chorioaminitis (AOR = 4.37, 95%CI: 1.53, 12.50), midline skin incision (AOR = 5.19, 95% CI: 1.87, 14.37 and post-operative hemoglobin less than 11 g/deciliter (AOR = 5.28, 95%CI: 1.97, 14.18) were significantly associated with surgical site infection. Conclusions Pregnancy induced hypertension, chorioaminitis, midline skin incision and post-operative hemoglobin of less than 11 g/deciliter were independent factors associated with surgical site infection. Cesarean deliveries with concomitant pregnancy induced hypertension, chorioaminitis and post-operative anemia needs special care and follow up until surgical site infection is ruled out. It is also advisable to reduce generous midline skin incision and better replaced with pfannensteil incision.

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“…Most patients treated at West Virginia University Hospital are from rural West Virginia and have many of the inequities associated with that population. 9 Our primary objective was to examine the existing attitudes and knowledge of medical professionals in the care and treatment of transgender individuals within a rural tertiary care center. As a secondary outcome, we compared results from two cohorts that provide medical services at WVU: residents and faculty physician providers.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes of Health Care Providers Toward Transgender Patients Within a Rural Tertiary Care Center

et al. 2019

Self Cite

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Purpose: Members of the transgender community face significant health disparities within our society, especially within the state of West Virginia, which is primarily rural. We sought to examine and compare existing attitudes and knowledge of resident and faculty physician medical professionals at our institution about treating transgender individuals within a rural tertiary care center.Methods: The Medical Practitioner Attitudes Towards Transgender Patients (MP-ATTS) survey and the Medical Practitioner Beliefs and Knowledge about Treating Transgender Patients (MP-BKTTP) survey were sent to all faculty and resident physicians at West Virginia University Hospitals. Demographics included information about gender, rurality of hometown, race, and description of medical practitioner status (i.e., years out of residency, residency status).Findings: In general, there were positive attitudes and reception of the survey among residents and faculty physicians. 76.45% of providers assumed that their patients were not transgender. More than 40% of respondents believed that they would need further education about transgender patients to provide appropriate health care. Male health care providers had significantly higher negative perceptions of the transgender community (N=85, M=4.46, standard deviation [SD]=0.55, p<0.0001) and perceived fewer barriers due to personnel (N=80, M=3.24, SD=0.96, p<0.0001).Conclusion: A clear need exists for increased training in transgender health care among physicians taking care of this patient population. A gender divide exists among health care providers within West Virginia over attitudes regarding the transgender community. Further studies are needed to fully understand the health care needs and barriers of the transgender population.

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Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Cited by 19 publications

References 27 publications

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

Surgical site infection and associated factors among women underwent cesarean delivery in Debretabor General Hospital, Northwest Ethiopia: hospital based cross sectional study

Knowledge and Attitudes of Health Care Providers Toward Transgender Patients Within a Rural Tertiary Care Center

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