Surgical site infection after cesarean section: Implementing 3 changes to improve the quality of patient care

Corcoran, Siobhan; Jackson, Valerie; Coulter-Smith, S; Loughrey, J. P. R.; McKenna, Peter; Cafferkey, Mary T.

doi:10.1016/j.ajic.2013.04.020

Cited by 43 publications

(30 citation statements)

References 24 publications

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“…Variation in reported infection rates can often be attributed to different populations, time periods and definitions of surgical site infection, secular trends and improvements in health care. 17 For example, Wloch and colleagues 5 found a considerably higher infection rate than we did, possibly owing to higher prevalence of comorbidities such as diabetes and active follow-up. The decrease in our rate over a 16-year period, from 5.2% to 2.0%, is similar to the absolute decrease of 2.05% reported in an Australian study 4 and to trends in health-care-associated infections seen in the United States.…”

Section: Discussionmentioning

confidence: 88%

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study

et al. 2017

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Background:The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. Methods:We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan. 1, 1997 and Dec. 31, 2012. Logistic regression with generalized estimating equations was used to determine risk factors for infection.Results: A total of 25 123 women had 33 991 cesarean deliveries over the study period. Of the 25 123, 923 had surgical site infections, giving an incidence rate of 2.7% (95% CI 2.54%-2.89%); the incidence decreased over time. Risk factors for infection (adjusted odds ratios ≥ 1.5) were prepregnancy weight 87.0 kg or more, gaining 30.0 kg or more during pregnancy, chorioamnionitis, maternal blood transfusion, anticoagulation therapy, alcohol or drug abuse, second stage of labour before surgery, delivery in 1997-2000 and delivery in a hospital performing 130-1249 cesarean deliveries annually. Women who gave birth earlier in the study period, those who gave birth in a hospital with 130-949 cesarean deliveries per year and those with more than 1 fetus were at a significantly higher risk for surgical site infection before discharge; women who smoked were at significantly higher risk for surgical site infection after discharge.Interpretation: Most risk factors are known before delivery, and some are potentially modifiable. Although the incidence of surgical site infection decreased over time, targeted clinical and infection prevention and control interventions could further reduce the burden of illness associated with this health-care-related infection. Abstract ResearchResearch CMAJ OPEN CMAJ OPEN, 5(3) E547

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Section: Discussionmentioning

confidence: 88%

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study

et al. 2017

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“…[22,35] Emergency CS has been linked to SSI through more frequent vaginal examinations with greater opportunity for membranes to rupture before delivery, highly urgent operation, less concerns about sterility, and absence of prophylactic antibiotics on time. [36][37][38] Some authors found Type of CS (either emergency or elective) was not a significant risk factor of SSI. [19,25] A vertical incision of CS was mentioned by many papers to increase the risk of SSI and may lead to formation of a hematoma due to less vascular tissues, while a transverse incision was associated with less wound dehiscence.…”

Section: Discussionmentioning

confidence: 99%

Post Cesarean Section Surgical Site Infection; Incidence and Risk Factors

2017

IJSR

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Abstract:The rate of births delivered by cesarean section (CS) has gone up substantially all over the world. Post-cesarean surgical site infection (SSI) is a common cause of maternal morbidity and mortality that results in prolonged period of hospitalization with increased cost and direct health implications, especially in low socioeconomic population, resource-restricted settings, and war-related conditions with internal forced movement. This study was aimed to find incidence of post cesarean section surgical site infection withthe accompanying risk factors.Pregnant ladies admitted to department of obstetrics and gynecology at Medical City Hospital in Baghdad who had undergone CSs were followed up prospectively from first of January 2017 till end of June 2017. Full medical evaluation was done to assess all clinical, laboratory, and sociodemographic characteristics ofboth; patients and controls. Statistical comparison was measured to appraise the important risk factors.A total of 3036 pregnant ladies were recruited, 191 patients had SSI with and an incidence rate of 6.3%. The above-mentioned 191 patients constituted of 93 (48.7%) internally moved patients due to the war, while they were 97 patients (25.4%) out of 382 control-group. Obesity, diabetes mellitus, emergency CS, vertical incision, interrupted suturing, and rupture of membranes before CS, were significant risk factors of post CS SSI. Rate and several risk factors of post CS SSI were studied to increase the public attention, and to take full steps to decrease it prophylactically.

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“…However, the literature shows variations in these rates, which can reach up to 11% by different methods of active search. 6,[18][19][20][21] SWISSI rates reported in the city of Belo Horizonte range from 3.0% by passive surveillance to 9.6% by active surveillance. 22,23 Although the ideal scenario is the active search for information based on the patient clinical evaluation, it is observed that surveillance carried out by telephone contact made by trained professionals can increase the reporting rate.…”

Section: Methodsmentioning

confidence: 99%

Índice De Risco Cirúrgico E Infecção De Ferida Operatória Em Puérperas Submetidas a Cesarianas

Chianca

Romanelli

Souza

et al. 2015

Rev Epidemiol Control Infect

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Surgical site infection after cesarean section: Implementing 3 changes to improve the quality of patient care

Cited by 43 publications

References 24 publications

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study

Post Cesarean Section Surgical Site Infection; Incidence and Risk Factors

Índice De Risco Cirúrgico E Infecção De Ferida Operatória Em Puérperas Submetidas a Cesarianas

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