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Cesarean wound infection

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https://www.readbyqxmd.com/read/29217927/magnitude-and-factors-associated-with-post-cesarean-surgical-site-infection-at-hawassa-university-teaching-and-referral-hospital-southern-ethiopia-a-cross-sectional-study
#1
Samuel Wodajo, Mehretu Belayneh, Samson Gebremedhin
Background: Surgical site infection (SSI) after cesarean section (CS) increases maternal morbidity, hospital stay and medical cost. However, in Ethiopia, limited evidence exists regarding the magnitude and risk factors of post-CS wound infection. The purpose of this study was to determine the prevalence of - and factors associated with the problem among mothers who gave birth in Hawassa University Teaching and Referral Hospital, Southern Ethiopia. Methods: Hospital based cross-sectional study was conducted based on the medical records of 592 women who underwent CS from June 2012 to May 2013...
May 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29215155/prophylactic-antibiotics-before-cord-clamping-in-cesarean-delivery-a-systematic-review
#2
Claudia Bollig, Monika Nothacker, Cornelius Lehane, Edith Motschall, Britta Lang, Joerg J Meerpohl, Christine M Schmucker
The number of clinical trials investigating the optimal timing of prophylactic antibiotics in cesarean section increased rapidly over the last few years. We conducted a systematic review to inform up-to date evidence-based guidelines to prevent postpartum infectious morbidity in the mother and rule out any safety issues related to antepartum antibiotic exposure in infants MATERIAL AND METHODS: Four bibliographic databases were searched for published reports of trials. Ongoing or unpublished studies were searched in Clinicaltrials...
December 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29112658/adding-azithromycin-to-cephalosporin-for-cesarean-delivery-infection-prophylaxis-a-cost-effectiveness-analysis
#3
Ashley E Skeith, Brenda Niu, Amy M Valent, Methodius G Tuuli, Aaron B Caughey
OBJECTIVE: To investigate the cost-effectiveness of adding azithromycin to standard cephalosporin regimens of cesarean delivery prophylaxis by considering the maternal outcomes in the current and potential subsequent pregnancies. METHODS: A cost-effectiveness model was created using TreeAge to compare the outcomes of using azithromycin-cephalosporin with cephalosporin alone in a theoretical cohort of 700,000 women, the approximate number of nonelective cesarean deliveries annually in the United States that occur during labor or after membrane rupture...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29094482/maternal-peripartum-septic-shock-caused-by-intrauterine-infection-with-edwardsiella-tarda-a-case-report-and-review-of-the-literature
#4
Yuki Miyazawa, Keisuke Murakami, Yuichiro Kizaki, Yukiko Itaya, Yasushi Takai, Hiroyuki Seki
Edwardsiella tarda (E. tarda) is a rare pathogen in humans, especially during the peripartum period. Only a few cases of fatal neonatal infection with E. tarda have been reported. Herein, we describe a case of maternal septicemia caused by E. tarda following peripartum chorioamnionitis. The mother developed septic shock, disseminated intravascular coagulation and a post-cesarean wound hematoma with abscess. Her condition improved with multidisciplinary therapy including blood transfusion, antimicrobial agents, recombinant thrombomodulin and surgical debridement...
November 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29090986/prophylactic-negative-pressure-wound-therapy-in-obese-patients-following-cesarean-delivery
#5
Maureen Ayers Looby, Rachel Isaksson Vogel, Ananta Bangdiwala, Barbara Hyer, Kamalini Das
OBJECTIVE: Negative pressure therapy (NPT) offers the potential to reduce infection in obese patients. The goal of this study was to explore the association between NPT use and infection after cesarean delivery among obese women. METHODS: We initiated a hospital protocol wherein women with a body mass index (BMI) of 40 kg/m2 or greater who delivered after January 1, 2011 were to receive NPT following cesarean section. A retrospective comparison of surgical site infection (SSI) in women receiving the intervention to a similar group with a BMI of 40 kg/m2 or greater, a historical control group of women who delivered before January 1, 2011...
October 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29020834/high-transverse-skin-incisions-may-reduce-wound-complications-in-obese-women-having-cesarean-sections-a-pilot-study
#6
Robert B Walton, Kelsey L Shnaekel, Songthip T Ounpraseuth, Peter G Napolitano, Everett F Magann
OBJECTIVE: Women having cesarean section have a high risk of wound complications. Our objective was to determine whether high transverse skin incisions are associated with a reduced risk of cesarean wound complications in women with BMI greater than 40. METHODS: A retrospective cohort study was undertaken of parturients ages 18-45 with BMI greater than 40 having high transverse skin incisions from January 2010 to April 2015 at a tertiary maternity hospital. Temporally matched controls had low transverse skin incisions along with a BMI greater than 40...
November 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29016591/caesarean-section-during-second-stage-of-labor-in-a-tertiary-centre
#7
Padma Gurung, Sameer Malla, Sushma Lama, Anagha Malla, Alka Singh
BACKGROUND: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour. METHODS: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29016508/prophylactic-negative-pressure-wound-therapy-for-obese-women-after-cesarean-delivery-a-systematic-review-and-meta-analysis
#8
REVIEW
Marcela C Smid, Sarah K Dotters-Katz, Matthew Grace, Sarah T Wright, Margaret S Villers, Abbey Hardy-Fairbanks, David M Stamilio
OBJECTIVE: To summarize available studies on wound complication outcomes after prophylactic negative pressure wound therapy for obese women (body mass index 30 or greater). DATA SOURCES: We conducted a systematic review and meta-analysis using electronic database search (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Google scholar, and Web of Science), Cochrane, and trial registries including ClinicalTrials.gov. METHODS OF STUDY SELECTION: We conducted an electronic search of research articles from 1966 to January 2017 for randomized controlled trials (RCTs), prospective cohort, and retrospective cohort studies of negative pressure wound therapy compared with standard dressing after cesarean delivery among obese women...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28969197/neglected-necrotizing-fasciitis-a-rare-complication-of-spinal-anaesthesia
#9
Karikal Chakaravarthi, Ashish Gupta, Lileswar Kaman
Necrotizing Fasciitis (NF) is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. NF classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites. NF secondary to spinal anaesthesia in a young postpartum female is extremely rare. Here we are describing a young postpartum female who underwent cesarean section for the delivery of child but developed NF of the back starting from the site of spinal needle insertion. She was referred to our center after 21 days of surgery with extensive NF...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28964729/-how-do-i-prevent-caesarean-wound-infections-in-obese-patients-in-2017
#10
B Ripamonti, T Raia-Barjat, C Chauleur, P Mathevet
Obesity is an important risk factor of cesarean section and is associated with an increased risk of wound complications such as infections. This review focuses on the available strategies to limit complications in this population. Choice of antiseptic solution, appropriate dose and type of antibiotic prophylaxy, suture closure of subcutaneous fat, suture skin closure and closed incision negative pressure wound therapy may reduce the risk of wound infections associated with cesarean section in obese patients...
September 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28951263/prophylactic-negative-pressure-wound-therapy-after-cesarean-is-associated-with-reduced-risk-of-surgical-site-infection-a%C3%A2-systematic-review-and-meta-analysis
#11
REVIEW
Lulu Yu, Ryan J Kronen, Laura E Simon, Carolyn R T Stoll, Graham A Colditz, Methodius G Tuuli
OBJECTIVE: The objective of the study was to assess the effect of prophylactic negative-pressure wound therapy on surgical site infections and other wound complications in women after cesarean delivery. DATA SOURCES: We searched Ovid Medline, Embase, SCOPUS, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. STUDY ELIGIBILITY CRITERIA: We included randomized controlled trials and observational studies comparing prophylactic negative-pressure wound therapy with standard wound dressing for cesarean delivery...
September 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885895/meta-analysis-of-comparative-trials-evaluating-a-prophylactic-single-use-negative-pressure-wound-therapy-system-for-the-prevention-of-surgical-site-complications
#12
REVIEW
Vicki Strugala, Robin Martin
BACKGROUND: We report the first meta-analysis on the impact of prophylactic use of a specific design of negative pressure wound therapy (NPWT) device on surgical site complications. METHODS: Articles were identified in which the specific single-use NPWT device (PICO(⋄), Smith & Nephew) was compared with standard care for surgical site infection (SSI), dehiscence, or length of stay (LOS). Risk ratio (RR) ±95% confidence interval (CI) (SSI; dehiscence) or mean difference in LOS ±95% CI was calculated using RevMan v5...
October 2017: Surgical Infections
https://www.readbyqxmd.com/read/28796687/comparison-of-subcuticular-suture-type-for-skin-closure-after-cesarean-delivery-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
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...
September 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
#14
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
#15
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
#16
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
#17
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
#18
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...
August 2017: Surgical Infections
https://www.readbyqxmd.com/read/28638306/effect-of-maternal-obesity-on-maternal-fetal-transfer-of-preoperative-cefazolin-at-cesarean-section
#19
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
#20
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
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