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Wound infection

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By M Munn
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
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
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
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
Nelson C Echebiri, M Maya McDoom, Meaghan M Aalto, Jessie Fauntleroy, Nagammai Nagappan, Vanessa M Barnabei
OBJECTIVE: To evaluate the economic benefit of prophylactic negative pressure wound therapy on a closed laparotomy incision after cesarean delivery in comparison with standard postoperative dressing. METHODS: We designed a decision-analytic model from a third-party payer's perspective to determine the cost-benefit of prophylactic application of negative pressure wound therapy compared with standard postoperative dressing on a closed laparotomy incision after cesarean delivery...
February 2015: Obstetrics and Gynecology
Lindsay Maggio, David P Nicolau, Melissa DaCosta, Dwight J Rouse, Brenna L Hughes
OBJECTIVE: To compare adipose tissue concentration among obese women receiving 2 g compared with 3 g of precesarean cefazolin prophylaxis. METHODS: This was a double-blind randomized controlled trial of women with singleton gestations and body mass indexes (BMIs) of 30 or greater at their first prenatal visit undergoing cesarean delivery at term. Women were randomly allocated, stratified by BMI, to receive 2 g or 3 g of cefazolin. Subcutaneous adipose tissue was harvested twice: before (opening) fascial incision and after (closing) fascial closure...
May 2015: Obstetrics and Gynecology
Brigid M Gillespie
No abstract text is available yet for this article.
July 2015: Obstetrics and Gynecology
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
Diogo Ayres-de-Campos
Caesarean section in obese patients is associated with an increased risk of surgical wound complications, including haematoma, seroma, abscess and dehiscence. This review focusses on the available strategies to decrease wound complications in this population, and on the clinical management of these situations. Appropriate dose of prophylactic antibiotics, closure of the subcutaneous tissue, and avoidance of subcutaneous drains reduce the incidence of wound complications associated with caesarean section in obese patients...
April 2015: Best Practice & Research. Clinical Obstetrics & Gynaecology
Haitham W Tuffaha, Brigid M Gillespie, Wendy Chaboyer, Louisa G Gordon, Paul A Scuffham
BACKGROUND: Obese women undergoing cesarean section are at increased risk of postoperative infection. There is growing interest in negative pressure wound therapy (NPWT) to prevent closed surgical incision complications including surgical site infection; however, the evidence on the effectiveness and cost-effectiveness of this technology is limited. The objective of this study was to evaluate the cost-effectiveness of NPWT compared with that of standard dressing in preventing surgical site infection in obese women undergoing elective cesarean section based on current evidence and to estimate the value and optimal design of additional research to study this technology...
May 15, 2015: Journal of Surgical Research
Sara H Swift, M Bridget Zimmerman, Abbey J Hardy-Fairbanks
OBJECTIVE: To evaluate the effect of a single-use negative pressure wound therapy (NPWT) system on postoperative complications after cesarean delivery. STUDY DESIGN: A historical control cohort of women was collected as part of a quality improvement project over a 6-month period. All women with at least 1 risk factor for postoperative complications were included in this control cohort. An intervention cohort of 110 women with at least 1 risk factor for postoperative complications was eligible to have a single-use NPWT system placed at the time of cesarean delivery...
May 2015: Journal of Reproductive Medicine
Homa K Ahmadzia, Emily M Patel, Dipa Joshi, Caiyun Liao, Frank Witter, R Phillips Heine, Jenell S Coleman
OBJECTIVE: To estimate whether morbidly obese gravid patients were less likely to develop a surgical site infection after receiving a higher dose of preoperative prophylactic antibiotics. METHODS: A retrospective cohort study of morbidly obese pregnant women undergoing cesarean delivery was conducted at two tertiary care centers from 2008 to 2013. Exposure was defined as receiving 2 g compared with 3 g cefazolin preoperatively. Disease was defined by diagnosis of a surgical site infection using Centers for Disease Control and Prevention criteria...
October 2015: Obstetrics and Gynecology
Ivan M Ngai, Anne Van Arsdale, Shravya Govindappagari, Nancy E Judge, Nicole K Neto, Jeffrey Bernstein, Peter S Bernstein, David J Garry
OBJECTIVE: To compare chlorhexidine with alcohol, povidone-iodine with alcohol, and both applied sequentially to estimate their relative effectiveness in prevention of surgical site infections after cesarean delivery. METHODS: Women undergoing nonemergent cesarean birth at greater than 37 0/7 weeks of gestation were randomly allocated to one of three antiseptic skin preparations: povidone-iodine with alcohol, chlorhexidine with alcohol, or the sequential combination of both solutions...
December 2015: Obstetrics and Gynecology
Hongye Wang, Shukun Hong, Hongtao Teng, Lujun Qiao, Hongmei Yin
OBJECTIVE: To compare the clinical efficacy between subcuticular sutures and staples for skin closure after cesarean delivery. METHODS: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science were searched. Only RCTs comparing subcuticular sutures to staples following cesarean delivery were included. The primary outcome was the incidence of wound complications, consisting of wound infection, wound separation, hematoma and seroma. Risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI) was calculated...
November 2016: Journal of Maternal-fetal & Neonatal Medicine
Methodius G Tuuli, Jingxia Liu, Molly J Stout, Shannon Martin, Alison G Cahill, Anthony O Odibo, Graham A Colditz, George A Macones
BACKGROUND: Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. METHODS: In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine-alcohol for preoperative skin antisepsis was superior to the use of iodine-alcohol for the prevention of surgical-site infection after cesarean delivery...
February 18, 2016: New England Journal of Medicine
Joseph L Fitzwater, Alan T N Tita
Cesarean wound infections represent a significant health and economic burden. Several modifiable risk factors have been identified for their development. Understanding these risks and techniques to manage cesarean wounds is essential for providers. In this article, these factors and prophylactic and therapeutic interventions are reviewed.
December 2014: Obstetrics and Gynecology Clinics of North America
Omar M Young, Imam H Shaik, Roxanna Twedt, Anna Binstock, Andrew D Althouse, Raman Venkataramanan, Hyagriv N Simhan, Harold C Wiesenfeld, Steve N Caritis
OBJECTIVE: The objective of the study was to compare the pharmacokinetics of 2 g and 3 g doses of cefazolin when used for perioperative prophylaxis in obese gravidae undergoing cesarean delivery. STUDY DESIGN: We performed a double-blinded, randomized controlled trial from August 2013 to April 2014. Twenty-six obese women were randomized to receive either 2 or 3 g intravenous cefazolin within 30 minutes of a skin incision. Serial maternal plasma samples were obtained at specific time points up to 8 hours after drug administration...
October 2015: American Journal of Obstetrics and Gynecology
Itzhak Brook
Anaerobes are the most predominant components of the normal human skin and mucous membranes bacterial flora, and are a frequent cause of endogenous bacterial infections. Anaerobic infections can occur in all body locations: the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin, and soft tissues. Treatment of anaerobic infection is complicated by their slow growth in culture, by their polymicrobial nature and by their growing resistance to antimicrobials. Antimicrobial therapy is frequently the only form of therapy needed, whereas in others it is an important adjunct to drainage and surgery...
January 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Erin Ward, Patrick Duff
BACKGROUND: Prophylactic antibiotics are of proven value in decreasing the frequency of postcesarean endometritis. The beneficial effect of prophylaxis is enhanced when the antibiotics are administered before the surgical incision as opposed to after the clamping of the umbilical cord. However, the optimal antibiotic regimen for prophylaxis has not been established firmly. OBJECTIVE: The purpose of this study was to compare 3 different antibiotic regimens for the prevention of postcesarean endometritis...
June 2016: American Journal of Obstetrics and Gynecology
2016-04-17 12:55:37
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