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Cesarean wound infection

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https://www.readbyqxmd.com/read/28796687/comparison-of-subcuticular-suture-type-for-skin-closure-after-cesarean-delivery-a-randomized-controlled-trial
#1
Arin M Buresch, Anne Van Arsdale, Myriam Ferzli, Nicole Sahasrabudhe, Mengyang Sun, Jeffrey Bernstein, Peter S Bernstein, Ivan M Ngai, David J Garry
OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28717587/closed-incision-negative-pressure-therapy-in-obese-patients-undergoing-cesarean-delivery-a-randomized-controlled-trial
#2
Ravindu P Gunatilake, Geeta K Swamy, Leo R Brancazio, Michael P Smrtka, Jennifer L Thompson, Jennifer B Gilner, Beverly A Gray, Robert Phillips Heine
Background  Postcesarean wound morbidity is a costly complication of cesarean delivery for which preventative strategies remain understudied. Objective  We compared surgical site occurrences (SSOs) in cesarean patients receiving closed-incision negative-pressure therapy (ciNPT) or standard-of-care (SOC) dressing. Study Design  A single-center randomized controlled trial compared ciNPT (5-7 days) to SOC dressing (1-2 days) in obese women (body mass index [BMI] ≥ 35), undergoing cesarean delivery between 2012 and 2014...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#3
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28681107/comparison-of-maternal-and-fetal-complications-in-elective-and-emergency-cesarean-section-a-systematic-review-and-meta-analysis
#4
Xiao-Jing Yang, Shan-Shan Sun
BACKGROUND: Though the same types of complication were found in both elective cesarean section (ElCS) and emergence cesarean section (EmCS), the aim of this study is to compare the rates of maternal and fetal morbidity and mortality between ElCS and EmCS. METHODS: Full-text articles involved in the maternal and fetal complications and outcomes of ElCS and EmCS were searched in multiple database. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis...
July 5, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28672754/postpartum-infection-in-relation-to-maternal-characteristics-obstetric-interventions-and-complications
#5
Daniel Axelsson, Jan Brynhildsen, Marie Blomberg
The purpose was to evaluate the association between maternal characteristics, obstetrical interventions/complications and postpartum wound infections (WI), urinary tract infection (UTI) and endometritis. Furthermore, this study aimed to determine the time from delivery to onset of infections after discharge from the hospital. Three large Swedish Medical Health Registers were scrutinized for the period 2005-2012. A total of 582,576 women had 795,072 deliveries. Women with diagnosis codes for WIs, UTIs or endometritis, from delivery to 8 weeks postpartum, were compared to non-infected women...
June 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28654355/a-prognostic-scoring-tool-for-cesarean-organ-space-surgical-site-infections-derivation-and-internal-validation
#6
Srisuda Assawapalanggool, Nongyao Kasatpibal, Supatra Sirichotiyakul, Rajin Arora, Watcharin Suntornlimsiri
BACKGROUND: Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. METHODS: Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool...
June 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28638306/effect-of-maternal-obesity-on-maternal-fetal-transfer-of-preoperative-cefazolin-at-cesarean-section
#7
Stephanie McKenney Groff, Wareef Fallatah, Samuel Yang, Jamie Murphy, Christopher Crutchfield, Mark Marzinke, Joanne Kurtzberg, Carlton K K Lee, Irina Burd, Azadeh Farzin
OBJECTIVES: American Congress of Obstetricians and Gynecologists recommends a single dose of antibiotic prophylaxis before all cesarean sections (C/S). This recommendation is based on pharmacokinetic studies that include only non-obese patients. We sought to evaluate 1) cefazolin plasma concentrations among obese and non-obese patients after administration of a 2-g cefazolin dose for prevention of surgical wound infections, and 2) whether cefazolin concentration in fetal circulation may be protective against pathogens that cause early onset neonatal sepsis...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28610569/a-novel-tamponade-agent-for-management-of-post-partum-hemorrhage-adaptation-of-the-xstat-mini-sponge-applicator-for-obstetric-use
#8
Maria I Rodriguez, Jeffrey T Jensen, Kenton Gregory, Mary Bullard, Paul Longo, Jerry Heidel, Alison Edelman
BACKGROUND: Although uterine tamponade is an effective treatment for postpartum hemorrhage (PPH), current methods have key limitations in their use, particularly in low resource settings. The XStat™ Mini Sponge Dressing (MSD) is approved for the management of non-compressible wounds in the battlefield/trauma setting. The MSD applies highly compressed medical sponges capable of stopping high-flow arterial bleeding within seconds. The objective of our study was to adopt the MSD for use in managing PPH...
June 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28601567/impact-of-evidence-based-interventions-on-wound-complications-after-cesarean-delivery
#9
Lorene A Temming, Nandini Raghuraman, Ebony B Carter, Molly J Stout, Roxane M Rampersad, George A Macones, Alison G Cahill, Methodius G Tuuli
BACKGROUND: A number of evidence-based interventions have been proposed to reduce post-cesarean delivery wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. OBJECTIVE: We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered before skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean delivery and to estimate residual risk factors for wound complications...
June 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28397204/outcomes-of-the-patients-diagnosed-incidentally-appendicitis-during-cesarean-section
#10
Mehmet Kulhan, Nur Gozde Kulhan, Umit Nayki, Cenk Nayki, Pasa Ulug, Nahit Ata, Hulya Toklucu
OBJECTIVES: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28372515/comparison-of-readmission-rates-between-groups-with-early-versus-late-discharge-after-vaginal-or-cesarean-delivery-a-retrospective-analyses-of-14-460-cases
#11
Evrim Bostanci Ergen, Enis Ozkaya, Ahmet Eser, Cigdem Abide Yayla, Cetin Kilicci, Ilter Yenidede, Ates Karateke
AIM: The aim of this retrospective analysis was to show the readmission rate of cases with and without early discharge following vaginal or cesarean delivery. METHODS: After exclusion of cases with pregnancy, delivery and neonatal complications, a total of 14.460 cases who delivered at Zeynep Kamil Women and Children's Health Training and Research Hospital were retrospectively screened from hospital database. Subjects were divided into two groups as Group 1:Early discharge (n = 6802) and Group 2:Late discharge (n = 7658)...
April 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28285425/total-bilateral-salpingectomy-versus-partial-bilateral-salpingectomy-for-permanent-sterilization-during-cesarean-delivery
#12
Shiri Shinar, Yair Blecher, Sharon Alpern, Ariel Many, Eran Ashwal, Uri Amikam, Aviad Cohen
PURPOSE: Sterilization via bilateral total salpingectomy is slowly replacing partial salpingectomy, as it is believed to decrease the incidence of ovarian cancer. Our objective was to compare short-term intra and post-operative complication rates of bilateral total salpingectomy versus partial salpingectomy performed during the course of a cesarean delivery. METHODS: A large series of tubal sterilizations during cesarean sections were studied in a single tertiary medical center between 1/2014 and 8/2016 before and after a policy change was made, switching from partial salpingectomy to total salpingectomy...
March 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28255256/postcesarean-wound-infection-prevalence-impact-prevention-and-management-challenges
#13
REVIEW
Sivan Zuarez-Easton, Noah Zafran, Gali Garmi, Raed Salim
Surgical site infection (SSI) is one of the most common complications following cesarean section, and has an incidence of 3%-15%. It places physical and emotional burdens on the mother herself and a significant financial burden on the health care system. Moreover, SSI is associated with a maternal mortality rate of up to 3%. With the global increase in cesarean section rate, it is expected that the occurrence of SSI will increase in parallel, hence its clinical significance. Given its substantial implications, recognizing the consequences and developing strategies to diagnose, prevent, and treat SSI are essential for reducing postcesarean morbidity and mortality...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28178058/risk-factors-for-postcesarean-maternal-infection-in-a-trial-of-extended-spectrum-antibiotic-prophylaxis
#14
RANDOMIZED CONTROLLED TRIAL
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-caesarean-section-on-wound-complications-a-meta-analysis
#15
REVIEW
V Pergialiotis, A Prodromidou, D N Perrea, S K Doumouchtsis
BACKGROUND: Caesarean wound complications are frequently observed in everyday practice. OBJECTIVES: To study whether subcutaneous tissue closure following caesarean 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...
June 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28153666/skin-closure-at-cesarean-delivery-glue-vs-subcuticular-sutures-a%C3%A2-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
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 has not yet been determined. OBJECTIVE: This study compared wound complications and scar healing following cesarean delivery between 2 methods of skin closure: glue (Dermabond; Ethicon, Somerville, NJ) and monofilament (Monocryl; Ethicon) epidermal sutures. STUDY DESIGN: We conducted a randomized controlled trial in which pregnant women undergoing a scheduled cesarean delivery were randomly assigned to skin (epidermis) closure with glue or with a monofilament synthetic suture...
April 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
#17
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 WHO near-miss criteria. Complicated and noncomplicated 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 four B-lynch suture placement procedures without maternal mortality...
February 9, 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
#18
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
#19
COMPARATIVE STUDY
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
#20
REVIEW
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
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