Skip to main content

Advertisement

Table 2 Interventions and techniques surrounding cesarean delivery

From: Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

  Wound infection Endometritis
Variables RR or OR References RR or OR References
Preoperative elements
 First generation cephalosporin vs. none 0.38 34 0.42 34
 First generation cephalosporin prior to skin incision vs. after cord clamp 0.7 11, 35-38 0.21-0.61 11, 35-38
 First generation cephalosporin 2 g vs. 3 g in morbidly obese women NS 40 - -
 Azithromycin
  In labor 0.35 9 0.62 9
  Non labor - - 0.11 41
 Chlorhexidine alcohol skin preparation vs. iodine 0.55 42, 43 NS 42
 Razor hair removal vs. clippers 2.1 44 - -
 Vaginal cleansing
  Chlorhexidine vs none NS 45 0.2 45
  Iodine vs none NS 10, 18, 46, 47 0.39 10, 18, 46, 47
   In labor NS 47 NS 47
   Not in labor NS 47 NS 47
   Ruptured membranes NS 46, 47 0.13 46, 47
   Intact membranes NS 47 NS 47
Intraoperative elements
 Uterine exteriorization NS 49 NS 49
 Manual removal of placneta vs. traction of umbilical cord - - 1.4-1.6 50, 51
 Intraabdominal irrigation NS 53 NS 52, 53
 Closure of subcutaneous tissue if >2 cma NS 54 - -
 Subcutaneous drain NS 55, 56 - -
 Suture skin closure vs. stapleb NS 6, 57, 58 - -
Postoperative elements
 Dressing removal between 24 and 48 h vs. 6 h NS 7 - -
  1. RR relative risk; OR odds ratio; NS not statistically significant; CI confidence interval
  2. aWound complications (hematoma, seroma, and infection) - RR 0.66; 95%CI 0.48, 0.91; Wound separation - RR 0.42; 95%CI 0.24, 0.75
  3. bWound complications (wound infection, hematoma, seroma, or separation of 1 cm or longer) -adjusted OR 0.43; 95%CI 0.23, 0.78; wound separation - adjusted OR 0.20; 95%CI 0.07, 0.51