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Prevention of Cesarean Delivery Surgical Site Infections

Shea, Sarah K., MD*; Soper, David E., MD

Obstetrical & Gynecological Survey: February 2019 - Volume 74 - Issue 2 - p 99–110
doi: 10.1097/OGX.0000000000000645
CME ARTICLES
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Importance Surgical site infection (SSI) is a common complication of cesarean delivery. Seen in up to 12% of cesarean deliveries, it is a major cause of prolonged hospital stay and a burden to the healthcare system. Interventions and techniques must be identified to decrease the risk of cesarean delivery SSIs.

Objective We review the categories of SSI, current studies that have focused on various interventions to decrease SSI, and preoperative, intraoperative, and postoperative recommendations for cesarean delivery SSI prevention.

Evidence Acquisition A thorough search of PubMed for all current literature was performed. Various surgical interventions and techniques were reviewed. We included studies that looked at preoperative, intraoperative, and postoperative interventions for SSI prevention.

Results We have summarized several surgical interventions and techniques as well as current consensus statements to aid the practitioner in preventing SSIs after cesarean delivery.

Conclusions and Relevance Upon analysis of current data and consensus statements pertaining to cesarean deliveries, there are certain preoperative, intraoperative, and postoperative interventions and techniques that can be recommended to decrease the risk of cesarean delivery SSI.

Target Audience Obstetricians and gynecologists; family physicians

Learning Objectives After completing this CME activity, physicians should be better able to evaluate preoperative considerations when preparing for a cesarean delivery; distinguish the recommended antiseptic choices for preoperative cleansing/prepping before cesarean delivery; propose the appropriate use of prophylactic antibiotics for prevention of cesarean delivery SSI; and select the surgical techniques that have been shown to decrease the risk of cesarean delivery SSI.

*Maternal-Fetal Medicine Fellow, and

Professor and Director, Division of Specialists in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC

All authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.

Correspondence requests to: Sarah K. Shea, MD, Division of Specialists in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Medical University of South Carolina, Suite 634, Charleston, SC 29425. E-mail: shea@musc.edu.

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