scholarly journals Supplemental Perioperative Oxygen (80% FIO2) for the Prevention of Surgical Site Infection after Emergency Cesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bleixen Admadé ◽  
Osvaldo Reyes
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infection ◽  
Controlled Trial ◽  
Surgical Site Infections ◽  
Supplemental Oxygen ◽  
Site Infection ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Significant Difference ◽  
Oxygen Group

Objective. Cesarean section can be a lifesaving procedure. However, as with many surgeries, it is not exempt of complications. Surgical site infections generate higher costs, serious morbidity, and mortality. This study evaluates the benefits of perioperative oxygen to prevent surgical site infections. Methods. We conducted a randomized controlled trial to assess the effects of perioperative oxygen to prevent surgical site infection after emergency cesarean section. Patients were randomized to receive either oxygen (80% FIO2) during cesarean section plus two hours postsurgery or no supplemental oxygen. A sample of 326 patients was calculated for the primary outcome (163 in each group) and they were evaluated daily before leaving the hospital, at days 15 and 30. Results. Initially, 360 patients were enrolled, from which 17 were excluded (sample size: 343 (179 patients in the air group and 164 in the oxygen group)). We found no significant difference in the incidence of surgical site infection between these two groups at any of the evaluation times. Conclusion. In this study of patients with emergency cesarean section, we showed that the use of supplemental oxygen does not reduce the incidence of surgical site infection. This trial is registeres with ClinicalTrials.gov NCT01340534.

scholarly journals Puerperal Complications in a Tertiary Hospital

2021 ◽  
Vol 23 (4) ◽  
pp. 329-333
Author(s):  
Hima Rijal ◽  
Suvana Maskey
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infection ◽  
Medical Condition ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Site Infection ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

Postnatal period is considered as an important part in reproductive life of women. Even though the antenatal phase and labour are utmost important, puerperal phase of pregnancy cannot be overlooked. Puerperal complication can sometime lead to diabilities for lifelong of women. For the prevention of postnatal complication, antenatal prepadareness is needed. The objective of this study was to find out the incidence of puerperal complications and associated risk factors. This is a retrospective, descriptive study conducted at Tribhuvan University Teaching Hospital, Department of Obstetrics and Gynaecology from April 2019 to March 2020. The cases of puerperal complications were noted from the record book from ward. The individual files were collected from record section. Data was collected from record files and analysed. Total number of deliveries were 4932 in one year. Out of which, 84 cases (1.7%) were admitted due to various puerperal complications. Majority of the women admitted with puerperal complications were between 21-29 years, 59.5%. Sixty-four percent (n=54) were primipara and 35.7%(n=30) were multipara. Seventy-six (90.5%) were term deliveries, 6(7%) were preterm and 2(2.4%) were post term deliveries. Sixty-two (74%) had emergency cesarean section as mode of delivery. Major indication of emergency cesarean section was fetal distress (29.8%, n=25). Surgical site infection (53/84,63%) was the commonest puerperal complication followed by puerperal sepsis (8/84,9.5%). Fifty- three cases of surgical site infection (SSI) were observed in patients who had undergone emergency cesarean section. Associated medical condition like hypertension, diabeties, anemia, obesity was seen in 33.5% (n=33) of the cases. Surgical Site Infection is the most common puerperal complication and commonly seen in women who had undergone emergency cesarean section.

scholarly journals Perioperative Prophylactic Antibiotics in Orthopaedic Surgery

2013 ◽  
Vol 3 (1) ◽  
pp. 5-10
Author(s):  
Bikram Prasad Shrestha ◽  
Surya Raj Niraula ◽  
Parvin Nepal ◽  
Guru Prasad Khanal ◽  
Navin Karn ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Randomized Controlled ◽  
Orthopaedic Patients ◽  
Significant Difference

Introduction: In our country, various institutes have different protocols for postoperative antibiotics. Many western literature have mentioned that administration of prophylactic antibiotics for longer than 24 hours has no advantage and may actually lead to superinfection with drug-resistant organisms. Because of environmental and theater condition most of the surgeon here are very reluctant to use prophylactic antibiotics for only 24 hours. The objective of the study was to find out the effect of duration of prophylactic antibiotics on the rate of surgical site infection in clean elective orthopaedic surgeries. Methods: This was a randomized controlled trial involving 207 clean elective orthopaedic patients undergoing surgery. The patients were divided into three groups which received intravenous prophylactic antibiotics for 24 hours, 48 hours and 48 hours followed by 7 days of oral antibiotics respectively. The patients were followed up for three months postoperatively. Result: There was no significant difference in the rate of surgical site infection among the three groups. Conclusion: We conclude that there is no benefit in prolonging prophylactic antibiotics beyond 24 hours. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9318   Nepal Orthopedic Association Journal 2013 Vol.3(1): 5-10

scholarly journals Effectiveness of preoperative bath using Chloroxylenol antiseptic soap on the incidence of post emergency Cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a Randomized Controlled trial

2020 ◽  
Author(s):  
Henry Lukabwe ◽  
Rogers Kajabwangu ◽  
Dale Mugisha ◽  
Horace Kizito ◽  
Baraka Munyanderu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Surgical Site Infections ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Regional Referral Hospital ◽  
Randomized Controlled ◽  
Emergency Cesarean ◽  
Sub Saharan

Abstract Introduction: Surgical Site Infections (SSIs) are infections that occur at or near the surgical incision within 30 days of the surgery. SSIs are the commonest form of hospital acquired infections in sub Saharan Africa with estimates between 15%-45%. Cesarean section (CS) is the single most important risk factor for postpartum infections, carrying a 5 to 20-fold increase in the risk of developing sepsis, with an even higher risk when the operation is an emergency. In sub Saharan Africa, the leading cause of maternal mortality is puerperal sepsis. There is a need for simple interventions that can reduce this burden of SSI in the limited resource settings. Therefore, the purpose of this study was to measure the effectiveness of chloroxylenol in reducing the incidence of post Cesarean section surgical site infections at Mbarara Regional Referral Hospital (MRRH).Methods: We conducted a single blinded randomized controlled trial at MRRH maternity ward in which women due for CS were randomized into either control or intervention arms. The intervention was a complete body bath with chloroxylenol antiseptic soap before the operation, while the control arm study participants received a standard pre-operative preparation procedures according to the existing ward protocol. All participants were followed up for 30 days and assessed using a standard SSI screening tool. Results: Ninety-six women were randomized, and 48 were assigned to either arm. The overall incidence of SSI was 30.21%. The incidence of SSI was significantly lower in the intervention compared to the control arm, at 6.25% in the intervention arm versus 54.17% in the control arm (p value<0.001). Chloroxylenol bath was protective of SSI with a 90% risk reduction for SSI (95% confidence interval of 67% – 97%). Conclusion: A preoperative bath with chloroxylenol for pregnant mothers is associated with a significantly lower risk of post Cesarean section surgical site infections. Health facilities with a high burden of post SSI should consider adding this simple and effective intervention to the existing infection prevention measures. Clinical Trials.gov registration (NCT03544710).

scholarly journals Trends of and factors associated with cesarean section related surgical site infections in Guinea

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Alexandre Delamou ◽  
Bienvenu Salim Camara ◽  
Sidikiba Sidibé ◽  
Alioune Camara ◽  
Nafissatou Dioubaté ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Retrospective Cohort ◽  
Surgical Site Infections ◽  
Obstetric Care ◽  
Medical Data ◽  
Site Infection ◽  
Care Policy ◽  
Factors Associated

Since the adoption of free obstetric care policy in Guinea in 2011, no study has examined the surgical site infections in maternity facilities. The objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in Guinean maternity facilities from 2013 to 2015. This was a retrospective cohort study using routine medical data from ten facilities. Overall, the incidence of surgical site infections following cesarean section showed a declining trend across the three periods (10% in 2013, 7% in 2014 and 5% in 2015, P<0.001). Women who underwent cesarean section in 2014 (AOR: 0.70; 95%CI: 0.57-0.84) and 2015 (AOR: 0.43; 95%CI: 0.34-0.55) were less likely to develop surgical site infections during hospital stay than women operated in 2013. In the contrary, women with comorbidities were more likely to experience surgical site infection (AOR: 1.54; 95% CI: 1.25-1.90) than those who did not have comorbidities. The reductions achieved in 2014 and 2015 (during the Ebola outbreak) should be sustained in the post-Ebola context.

scholarly journals Comparing the Effects of Cumin, Peppermint, and Milk of Magnesia on Gastrointestinal Complications after Caesarean Section

2016 ◽  
Vol 8 (12) ◽  
pp. 78 ◽  
Author(s):  
Maryam Tofighi Niaki ◽  
Zoleykha Atarod ◽  
Shabnam Omidvar ◽  
Mandana Zafari ◽  
Azar Aghamohammadi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Chi Square ◽  
Double Blind ◽  
Gastrointestinal Complications ◽  
Gynecology And Obstetrics ◽  
Emergency Cesarean ◽  
Gastrointestinal Problems ◽  
Significant Difference

<p><strong>CONTEXT:</strong> Gastrointestinal problems are common after Cesarean section. During the past three decades, there has been an increasing trend in the use of herbal plants in the treatment of various medical conditions.<strong></strong></p><p><strong>AIMS:</strong> This study aimed to compare the effects of cumin, peppermint with magnesium hydroxide (milk of magnesia; MOM) on gastrointestinal complications of Caesarean section.<strong></strong></p><p><strong>SETTINGS &amp; DESIGN:</strong> This randomized double-blind controlled trial was conducted in the Gynecology and Obstetrics Department of Imam Hospital (affiliated to Mazandaran University of Medical Sciences, Sari, Iran) during November 2013-August 2014. The project was approved by the Research Ethics Committee of Islamic Azad Medical University, Sari Branch (Iran).<strong></strong></p><p><strong>MATERIAL &amp; METHODS:</strong> A total of 83 patients undergoing non-emergency Cesarean delivery in Imam Hospital were randomly selected. Patients with underlying diseases, history of gastrointestinal problems, fever, intestinal adhesion, longer-than-usual Cesarean section, and lack of cooperation were excluded. The subjects were informed about the study objectives and procedure and asked to provide written informed consent. They were then randomly assigned into three groups of cumin, peppermint, MOM. Gastrointestinal complications were assessed 20, 40, 60, and 120 minutes after drug administration.</p><p><strong>STATISTICAL ANALYSIS USED:</strong> The collected data were analyzed using Fisher’s exact and chi-square tests in SPSS for Windows 18.0<strong>.</strong></p><p><strong>RESULTS:</strong><strong> </strong>There was no significant difference between three groups according to incidence of gastrointestinal side effects after Cesarean section at the mentioned intervals.</p><p><strong>CONCLUSIONS:</strong><strong> </strong>Cumin and peppermint were as effective as MOM.</p>

scholarly journals Effect of duration of pre-operative admission on surgical site infection in major abdominal surgeries: an observational study

2019 ◽  
Vol 8 (6) ◽  
pp. 2306
Author(s):  
Alka Shantiprakash Gupta ◽  
Arthika Shetty
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Surgical Patient ◽  
P Value ◽  
Site Infection ◽  
Admission Time ◽  
Long Run ◽  
Skin Flora ◽  
Significant Difference ◽  
Prolonged Hospital

Background: Surgical site infection (SSI) are second most common cause of mortality in surgical patient, situation has been further complicated by emergence of drug resistant strains. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stays, need for readmission, high end antibiotic treatment and re-surgery. The study was done to see if   incidence of SSI is decreased with decreased pre-operative admission time. Others factors associated with SSI were analysed including the microbiological spectrum.Methods: The study was an analytical, observational, case control study. Sixty (60) cases each of gynaecology and obstetrical post-operative patients who developed SSI within 30 days were taken as cases and who did not develop SSI were taken as controls and preoperative admission time was analysed in both cases and controls to observe if risk of surgical site infections decreases due to decreased exposure to nosocomial pathogens when the pre-operative admission time was less than 48 hours.Results: Author found that there was statistically significant difference in the time between surgery and admission in the gynaecological surgeries with p value 0.023, as compared to the obstetrics surgeries where there was no statistically significant difference. Common organism isolated was E. coli sensitive to gentamicin.Conclusions: From this study, it seems to be a good policy to evaluate the patient on OPD basis and admit them about 24 to 48 hours prior to the surgery rather them keeping them admitted for prolonged duration in wards for diagnostic evaluation. This prevents nosocomial contamination in the patient’s skin flora thereby preventing SSI. This practice not only conserves the hospital resources but also makes the patient turn over faster. Further this might in the long run reduce the antibiotic resistant hospital flora.

scholarly journals Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s377
Author(s):  
Feah Visan ◽  
Jenalyn Castro ◽  
Yousra Siam Shahada ◽  
Naser Al Ansari ◽  
Almunzer Zakaria
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Body Mass ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

scholarly journals Surgical site infection and its association with rupture of membrane following cesarean section in Africa: a systematic review and meta-analysis of published studies

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alemayehu Gonie Mekonnen ◽  
Yohannes Moges Mittiku
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Subcutaneous Tissue ◽  
Meta Analysis ◽  
Surgical Site Infections ◽  
Forest Plot ◽  
Site Infection ◽  
Manual Search ◽  
Inconsistency Index

Abstract Introduction Surgical site infection occurs within 30 days after a surgical procedure and involves the skin, subcutaneous tissue, and soft tissue. Surgical site infection following cesarean section is a common postoperative complication and is associated with maternal morbidity and mortality in resource-limited settings. Even though the proportion of surgical site infection and some risk factors were reported by kinds of literature, varying results were stated across studies. There is also limited knowledge on the association between postpartum surgical site infection and the rupture of membrane. Hence, this systematic review and meta-analysis was designed to estimate the pooled proportion of surgical site infection and its association with rupture of membrane following cesarean section in Africa. Methods Studies published from January 01, 2000 to January 30, 2020 were searched from MEDLINE via PubMed, Scopus, Medscape, Web-science and CINAHL databases to search relevant published articles. We also performed a manual search of reference lists of key articles to retrieve additional relevant articles. Initially, 559 records were identified and 15 studies included in the analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger’s test. Pooled estimates of proportion and odds ratio were calculated by a random-effects model with a 95% confidence interval (CI). Results The overall pooled proportion of surgical site infection following cesarean section was 10.21% (I2 = 86.8, p < 0.000; 95% CI = 8.36, 12.06). The odds of developing surgical site infection among women who had the rupture of membrane before delivery were nearly 6 times higher than those who had not a rupture of the membrane (AOR = 5.65, 95% CI: 3.95–8.07). Conclusions The proportion of surgical site infections following the cesarean section is relatively high. Women who had rupture of the membrane before delivery were more likely to develop surgical site infections following the cesarean section. Due attention should be given to the provision of prophylactic antibiotics that can reduce surgical site infection after cesarean delivery.

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