Response to ‘Caesarean sections at Royal Darwin Hospital’ letter

Incidence and Risk Factors for Surgical Site Infection following Emergency Cesarean Section: A Retrospective Case-Control Study

“…Smoking status, existing health conditions such as diabetes, age, or skin closure techniques were not found to contribute to an increased risk of infection in this study. This is in contrast to other research which has found significant relationships for smoking and delayed wound healing, 42 diabetes 28,43,44 and skin closure techniques. 45 Indeed Henman et al 28 found age was not associated with SSI in CS; however, other evidence suggests that up to the age of 65 years, there is an increased risk of SSI more generally, 46 possibly due to an impaired immune system.…”

“…This is in contrast to other research which has found significant relationships for smoking and delayed wound healing, 42 diabetes 28,43,44 and skin closure techniques. 45 Indeed Henman et al 28 found age was not associated with SSI in CS; however, other evidence suggests that up to the age of 65 years, there is an increased risk of SSI more generally, 46 possibly due to an impaired immune system. 47 An increase in age-related comorbidities could also increase the risk of developing an SSI following emergency CS.…”

“…25,26 Extended labour time and the complexities surrounding an emergency CS also impact the possibility of post-surgical infection. 27,28 However, there are some inconsistences; in a multicentre study of 4107 women who underwent a CS at 14 NHS hospitals in England, Wloch et al 29 found obesity (defined as BMI>30 kg/m 2 ), age <20 years and grade of surgeon to be significantly associated with developing an SSI. Obesity was also found to increase the risk of SSI within 30 days after CS in a case-control study of 240 women at a hospital in Ireland.…”