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Cesarean wound infection

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https://www.readbyqxmd.com/read/28178058/risk-factors-for-postcesarean-maternal-infection-in-a-trial-of-extended-spectrum-antibiotic-prophylaxis
#1
Kim A Boggess, Alan Tita, Victoria Jauk, George Saade, Sherri Longo, Erin A S Clark, Sean Esplin, Kristin Cleary, Ronald Wapner, Kelli Letson, Michelle Owens, Sean Blackwell, Carmen Beamon, Jeffrey M Szychowski, William Andrews
OBJECTIVE: To identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis. METHODS: We conducted a planned secondary analysis of a randomized clinical trial. Patients were 24 weeks of gestation or greater and delivered by cesarean after a minimum of 4 hours of ruptured membranes or labor. All participants received standard preincision prophylaxis and were randomized to receive azithromycin or placebo...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28176441/the-impact-of-subcutaneous-tissue-suturing-at-cesarean-section-on-wound-complications-a-meta-analysis
#2
Vasilios Pergialiotis, Anastasia Prodromidou, Despina N Perrea, Stergios K Doumouchtsis
BACKGROUND: Cesarean wound complications are frequently observed in everyday practice. OBJECTIVES: To study whether subcutaneous tissue closure following cesarean section results in decreased wound complications. SEARCH STRATEGY: We systematically searched Medline (1966-2016), Scopus (2004-2016), ClinicalTrials. gov (2008-2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together with reference lists from included studies...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28153666/skin-closure-at-cesarean-delivery-glue-versus-subcuticular-sutures-a-randomized-controlled-trial
#3
Yair Daykan, Maya Sharon-Weiner, Yael Pasternak, Keren Tzadikevitch-Geffen, Ofer Markovitch, Rivka Sukenik-Halevy, Tal Biron-Shental
BACKGROUND: The optimal choice of skin closure at cesarean delivery (CD) has not yet been determined. This study compared wound complications and scar healing following CD between two methods of skin closure: glue (Dermabond) and monofilament (Monocryl) epidermal sutures. STUDY DESIGN: We conducted a randomized controlled trial in which pregnant women undergoing a scheduled CD were randomly assigned to skin (epidermis) closure with glue or with a monofilament synthetic suture...
January 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28110586/prediction-of-maternal-near-miss-in-placenta-previa-a-retrospective-analysis-from-a-tertiary-center-in-ankara-turkey
#4
Bora Coskun, Iltac Akkurt, Rıza Dur, Mehmet O Akkurt, Seval Y Ergani, Ozerk T Turan, Bugra Coskun
AIM: To determine risk factors for severe complications during and after cesarean delivery (CD) in placenta previa (PP). METHODS: We reviewed retrospectively collected data from women with PP who underwent CD during a 6-year study period. We identified the complicated group based on the modified World Health Organization near-miss criteria. Complicated and non-complicated groups were compared considering clinical, laboratory, and sonographic features. RESULTS: Thirty-seven of 256 cases classified as near miss consisting of 14 peripartum hysterectomies, 12 uterine balloon placements, 10 great artery ligations, and 4 B-lynch suture placement procedures without maternal mortality...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27977577/negative-pressure-wound-therapy-aids-recovery-following-surgical-debridement-due-to-severe-bacterial-cellulitis-with-abdominal-abscess-post-cesarean-a-case-report-care-compliant
#5
Christopher N J Young, Ka Ying Bonnie Ng, Vanessa Webb, Sarah Vidow, Rajeswari Parasuraman, Sameer Umranikar
INTRODUCTION: Bacterial cellulitis post-Cesarean section is rare. Negative pressure wound therapy (NPWT) is widely used in various medical specialities; its effectiveness in obstetrics however remains the topic of debate-used predominantly as an adjunct to secondary intention specific to high-risk patient groups. Its application in the treatment of actively infected wounds post-Cesarean is not well documented. Here, we document NPWT in the treatment of an unusually severe case of bacterial cellulitis with abdominal abscess postpartum...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27870738/persistent-pain-after-cesarean-delivery-and-vaginal-delivery-a-prospective-cohort-study
#6
J Petter Kainu, Erja Halmesmäki, Kari T Korttila, P Johanna Sarvela
BACKGROUND: Persistent pain after cesarean delivery and vaginal delivery has been the subject of only a few research articles. The primary outcome of our prospective study was the incidence of persistent pain and its association to mode of delivery. We also studied the nature and intensity of pain after delivery. METHODS: A questionnaire was distributed on postpartum day 2 to 1052 women who had given birth vaginally and to 502 who had undergone cesarean delivery in a tertiary maternity hospital in Helsinki, Finland, in 2010...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27756714/multidetector-ct-appearance-of-the-pelvis-after-cesarean-delivery-normal-and-abnormal-acute-findings
#7
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...
November 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27695495/dialkylcarbamoyl-chloride-impregnated-dressing-for-the-prevention-of-surgical-site-infection-in-women-undergoing-cesarean-section-a-pilot-study
#8
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
https://www.readbyqxmd.com/read/27682034/adjunctive-azithromycin-prophylaxis-for-cesarean-delivery
#9
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27632411/incidence-of-wound-complications-in-cesarean-deliveries-following-closure-with-absorbable-subcuticular-staples-versus-conventional-skin-closure-techniques
#10
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...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27630910/effect-of-normal-saline-on-cleaning-uterine-cavity-during-cesarean-delivery
#11
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
https://www.readbyqxmd.com/read/27624413/effect-of-skin-coverage-method-following-subcuticular-suturing-on-wound-infection-rates-at-cesarean-delivery
#12
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
https://www.readbyqxmd.com/read/27583685/chlorhexidine-vaginal-wipes-prior-to-elective-cesarean-section-does-it-reduce-infectious-morbidity-a-randomized-trial
#13
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
https://www.readbyqxmd.com/read/27581586/dilatation-or-no-dilatation-of-the-cervix-during-cesarean-section-dondi-trial-a-randomized-controlled-trial
#14
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
https://www.readbyqxmd.com/read/27496602/risk-factors-and-microbiology-of-wound-infections-following-cesarean-delivery-experience-of-a-single-institution
#15
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
https://www.readbyqxmd.com/read/27352285/surgical-site-infection-in-cesarean-sections-with-the-use-of-a-plastic-sheath-wound-retractor-compared-to-the-traditional-self-retaining-metal-retractor
#16
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
https://www.readbyqxmd.com/read/27212612/-what-s-the-optimal-time-of-cesarean-section-antibiotic-prophylaxis-before-skin-incision-or-after-umbilical-cord-clamping-a-prospective-randomized-study
#17
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...
November 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27212261/cesarean-delivery-complications-in-women-with-morbid-obesity
#18
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
https://www.readbyqxmd.com/read/27179440/comparison-of-suture-materials-for-subcuticular-skin%C3%A2-closure-at-cesarean-delivery
#19
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
https://www.readbyqxmd.com/read/27082506/complications-and-route-of-delivery-in-a-large-cohort-study-of-hiv-1-infected-women-impaact-p1025
#20
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
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