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Wound infection

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29 papers 0 to 25 followers
By M Munn
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...
October 2017: American Journal of Obstetrics and Gynecology
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
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), (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
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
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 the 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...
August 2017: 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
2016-05-21 22:30:03
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