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Cesarean wound infection

Benedetta Gui, Francesco Maria Danza, Anna Lia Valentini, Maria Elena Laino, Alessandro Caruso, Brigida Carducci, Elena Rodolfino, Ersilia Devicienti, Lorenzo Bonomo
Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture...
October 19, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Paweł J Stanirowski, Anna Kociszewska, Krzysztof Cendrowski, Włodzimierz Sawicki
INTRODUCTION: Incisional surgical site infections (SSIs) occur in approximately 1.8-9.2% of patients undergoing cesarean section (CS) and contribute to prolonged hospitalization time and increased treatment costs. Dressings impregnated with dialkylcarbamoyl chloride (DACC) are an innovative approach to wound treatment based on a solely physical mechanism of action, and therefore can be used safely and without time restrictions in women during the puerperal and lactation period. MATERIAL AND METHODS: A single-blinded randomized, controlled pilot study was conducted at the Mazovian Bródno Hospital, a tertiary care hospital, between December 2013 and March 2014, and it evaluated the presence of superficial and deep SSIs in patients during the first 14 days after a CS...
October 1, 2016: Archives of Medical Science: AMS
Alan T N Tita, Jeff M Szychowski, Kim Boggess, George Saade, Sherri Longo, Erin Clark, Sean Esplin, Kirsten Cleary, Ron Wapner, Kellett Letson, Michelle Owens, Adi Abramovici, Namasivayam Ambalavanan, Gary Cutter, William Andrews
Background The addition of azithromycin to standard regimens for antibiotic prophylaxis before cesarean delivery may further reduce the rate of postoperative infection. We evaluated the benefits and safety of azithromycin-based extended-spectrum prophylaxis in women undergoing nonelective cesarean section. Methods In this trial conducted at 14 centers in the United States, we studied 2013 women who had a singleton pregnancy with a gestation of 24 weeks or more and who were undergoing cesarean delivery during labor or after membrane rupture...
September 29, 2016: New England Journal of Medicine
Tabitha L Schrufer-Poland, Maria P Ruiz, Samuel Kassar, Christopher Tomassian, Stacey D Algren, John D Yeast
OBJECTIVE: To determine if there is a significant difference in composite wound complications among traditional closure techniques versus absorbable subcuticular staple closure. STUDY DESIGN: This study is a retrospective cohort study of cesarean sections performed from January through September of 2014. Composite wound complications included surgical site infection, separation, and fluid collection. Medical records were reviewed and data including the patient demographics, comorbidities, closure type and wound complications were recorded...
August 3, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lobat Jafarzadeh, Hajar Hojjati
INTRODUCTION: Cesarean delivery is the most common and costly gynaecologic surgery, with an increase in rate all over the world. AIM: The present study aimed to estimate the effect of uterine cavity cleansing with normal saline solution during cesarean delivery on the rate of infection, fever, bleeding and postoperative gastrointestinal complications. MATERIALS AND METHODS: This study was a clinical trial carried out on 90 pregnant women who underwent elective cesarean delivery...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Jill M Westcott, Libby Crockett, Fang Qiu, Teresa G Berg
OBJECTIVE: The objective of this study was to determine whether use of cyanoacrylate skin glue following subcuticular skin closure was associated with a decrease in wound outcomes in comparison with subcuticular closure plus Steri-strips at cesarean delivery. METHODS: This was a retrospective cohort study of patients undergoing cesarean delivery at a single center over a two year period. The primary outcome of wound infection and secondary outcomes of wound separation and composite wound complication rate were assessed throughout the six week postpartum period...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
Magdy R Ahmed, Nisreen K Aref, Waleed A Sayed Ahmed, Farzana R Arain
OBJECTIVE: To evaluate the efficacy of preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes on rates of postcesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection). METHODS: This prospective randomized trial was conducted among 218 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization. After spinal anesthesia and catheterization under aseptic technique, the study group had preoperative vaginal cleansing using chlorhexidine 0...
September 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jade Kirscht, Christel Weiss, Jana Nickol, Sebastian Berlit, Benjamin Tuschy, Benjamin Hoch, Amelie-Verena Trebin, Thomas Große-Steffen, Marc Sütterlin, Sven Kehl
PURPOSE: To assess the effects of mechanical dilatation of the cervix during cesarean section on postoperative morbidity. METHODS: A total of 447 women with elective cesarean section were included in the Dondi trial (Dilatation or no dilatation of the cervix during cesarean section). The primary outcome measure of this randomized controlled trial was postpartum hemorrhage (PPH) within 6 weeks. Infectious morbidity (puerperal fever, endometritis, wound infection, and urinary tract infection), blood loss (need for blood transfusion or change in hemoglobin levels), and operating time were also evaluated...
September 1, 2016: Archives of Gynecology and Obstetrics
Gülşah Ilhan, Fatma Ferda Verit Atmaca, Abdurrahman Kaya, Ahmet Hasan Ergin, Ayşe Filiz Gökmen Karasu, Mehtap Turfan
AIMS: To determine the prevalence of wound infection following cesarean delivery, risk factors, common bacterial pathogens and their antibiotic sensitivity. MATERIAL-METHOD: The study population consisted of 5787 cesarean deliveries. All of the patients received 2 g doses of cephazolin perioperatively for antibiotic prophylaxis. Patients with wound infection who had two doses of 1 g cephazolin postoperatively and who were continued on oral preparations of 500 mg of cephuroxime twice daily for 5 days after hospital discharge were included in Group A...
October 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Larry Hinkson, Jan-Peter Siedentopf, Alexander Weichert, Wolfgang Henrich
OBJECTIVE: A cesarean section rate of up to 19.4% is reported worldwide. Surgical site infection occurs with rates of up to 13.5%. Plastic-sheath wound retractors show reduced rates of surgical site infections in abdominal surgery. There is limited evidence in women having cesarean sections. This study evaluates the use of the Alexis(®) O C-Section Retractor in the prevention of surgical site infection in patients undergoing their first planned cesarean section compared to the traditional Collins self-retaining metal retractor...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
A Khlifi, M Kouira, I Bannour, F Hachani, M Kehila, F Ferhi, A Bouslama, K Ben Jazia, M Fekih, H Khairi
OBJECTIVES: To compare the effect of antibiotics prophylaxis within 30 mins before skin incision (A) and after umbilical cord clamping (C) on the incidence of postoperative infections in patients undergoing elective caesarean section at Farhat Hached university teaching hospital. MATERIALS AND METHODS: We conducted a randomised clinical trial evaluating 279 patients undergoing elective caesarean section. Patients were randomly assigned a group number that allocated them to either arm of the study...
May 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Kelly Yamasato, Kurt Yoshino, Ann L Chang, Aaron B Caughey, Pai-Jong Tsai
OBJECTIVE: To compare cesarean complication rates between women with body mass index (BMI) 40-49.9 kg/m(2) and BMI ≥ 50 kg/m(2) and associations with surgical techniques. METHODS: This retrospective cohort study from 2009 to 2014 included women who underwent cesarean with delivery BMI ≥ 50 and an equal number with BMI 40-49.9. Wound infections and/or separations were compared. We also examined wound complication rates between skin closure techniques and self-retaining retractor use...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
Methodius G Tuuli, Molly J Stout, Shannon Martin, Roxane M Rampersad, Alison G Cahill, George A Macones
BACKGROUND: Subcuticular skin closure with suture after cesarean has been shown to result in lower rates of wound complications than with staple closure. However, the optimal choice of suture material for subcuticular skin closure is unclear. Vicryl (a braided multifilament synthetic suture; Ethicon, Somerville, NJ) and Monocryl (a monofilament synthetic suture; Ethicon) are the commonly used suture materials for subcuticular closure of transverse skin incisions after cesarean in the United States...
October 2016: American Journal of Obstetrics and Gynecology
Elizabeth G Livingston, Yanling Huo, Kunjal Patel, Ruth E Tuomala, Gwendolyn B Scott, Alice Stek
OBJECTIVE: To investigate complications of cesarean section in a cohort of HIV-infected pregnant women. METHODS: IMPAACT P1025 is a prospective cohort study of HIV-1-infected women and infants, enrolled 2002-2013, at clinical sites in the United States and Puerto Rico. Demographic, medical, and obstetric data were collected and analyzed including cesarean indications. The delivery route was categorized as elective cesarean (ECS) (before labor and <5 minutes before membrane rupture), nonelective cesarean (NECS) (all other cesareans) or vaginal delivery...
September 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Robert C Johnston, Lauryn Gabby, Tevy Tith, Kristina Eaton, Melissa Westermann, Deborah A Wing
OBJECTIVE: Nearly one-third of all births in the United States in 2013 were by cesarean delivery, with 6% complicated by diabetes. The purpose of this study was to correlate immediate postoperative hyperglycemia with wound morbidity in diabetic women who underwent cesarean delivery. METHODS: This retrospective case-control study was performed at UC Irvine Health and Miller Women's & Children's Hospital Long Beach between 2009 and 2015. Subjects included women with at least Class B diabetes mellitus who underwent cesarean birth...
May 5, 2016: Journal of Maternal-fetal & Neonatal Medicine
Ahmed A Tharwat, Amr H Yehia, Karim A Wahba, Abd-Elrhman G Ali
OBJECTIVE: Aim was to assess the efficacy and safety of incisional infiltration of lidocaine and epinephrine vs. lidocaine only to reduce postcesarean section (C/S) pain. MATERIAL AND METHODS: It was a prospective, randomized, controlled, double-blinded clinical trial that was conducted in two tertiary hospitals in Egypt and included 153 women undergoing C/S under general anesthesia. They were randomly divided into the following two groups: Group I (control group, number=78), in which the wound was infiltrated before skin closure with 20 mL of 2% lidocaine, and Group II (study group, number=75), in which the wound was infiltrated before skin closure with 20 mL of 2% lidocaine and epinephrine...
2016: Journal of the Turkish German Gynecological Association
David Peleg, Esther Eberstark, Steven L Warsof, Nadav Cohen, Inbar Ben Shachar
BACKGROUND: Following cesarean delivery, wound dressings are typically left over the incision for 24-48 hours. OBJECTIVE: The objective of this study was to determine if early removal of the wound dressing at 6 hours postsurgery has any effect on wound complications. STUDY DESIGN: This was a randomized, controlled study from August 2013 through January 2015 in which 320 low-risk women aged 18-44 years having scheduled primary, first repeat, or second repeat cesarean delivery were randomized for wound dressing removal at either 6 or 24 hours postsurgery...
September 2016: American Journal of Obstetrics and Gynecology
Srisuda Assawapalanggool, Nongyao Kasatpibal, Supatra Sirichotiyakul, Rajin Arora, Watcharin Suntornlimsiri
BACKGROUND: Cesarean surgical site infections (SSIs) are a major challenge in Thai-Myanmar border hospital settings. This study aimed to examine risk factors for SSIs after cesarean section. METHODS: This was a prospective cohort study conducted in a Thai-Myanmar border hospital between January 2007 and December 2012. Data were collected from the medical record database by trained infection control nurses. Stepwise multivariable logistic regression was used for risk factor analysis and expressed as a risk ratio (RR)...
September 1, 2016: American Journal of Infection Control
B Shrestha, R Marhatha, A Giri, S Jaisi, U Maskey
Surgical site infection is one of the most common complications following Lower Segment Cesarean Section, which accounts for prolonged hospital stay thereby increasing expense. Prophylactic antibiotics in cesarean section reduces surgical site infection significantly. The best protection is provided when tissue level of antibiotics are adequate before incision, without prejudice to neonatal infectious morbidity. The objective of this study was to compare the incidence of surgical site wound infection with prophylactic antibiotics given before skin incision and after cord clamping following delivery of baby...
December 2014: Nepal Medical College Journal: NMCJ
Melike Harfouche, Mina Hosseinipour, Stephen Kaliti, Jeffrey Wilkinson
The objective of this research study is to identify quality indicators of cesarean deliveries and determine their relationship to neonatal and maternal morbidity and mortality in one high volume maternity hospital in Lilongwe, Malawi. Demographic, perioperative, and postoperative data were collected on all cesarean deliveries over three months. Indicators of quality (antibiotic administration, use of oxytocin, decision-to-incision time, and uterine incision type) were compared to maternal morbidities (postpartum hemorrhage, fistula and wound infection) and neonatal mortality...
September 2015: African Journal of Reproductive Health
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