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Practices to Reduce Surgical Site Infections Among Women Undergoing Cesarean Section: A Review

Published online by Cambridge University Press:  20 May 2015

Rebeccah A. McKibben ,
Samantha I. Pitts ,
Catalina Suarez-Cuervo ,
Trish M. Perl  and
Eric B. Bass
Rebeccah A. McKibben*
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Samantha I. Pitts
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Catalina Suarez-Cuervo
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Trish M. Perl
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Eric B. Bass
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
*
Address correspondence to Rebeccah A. McKibben, MPH, 624 North Broadway, Room 680A, Baltimore, MD, 21205 ([email protected]).
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Abstract

OBJECTIVE

Surgical site infections (SSIs) are a leading cause of morbidity and mortality among women undergoing cesarean section (C-section), a common procedure in North America. While risk factors for SSI are often modifiable, wide variation in clinical practice exists. With this review, we provide a comprehensive overview of the results and quality of systematic reviews and meta-analyses on interventions to reduce surgical site infections among women undergoing C-section.

METHODS

We searched PubMed and the Cochrane Database of Systematic Reviews for systematic reviews and meta-analyses published between January 2000 and May 2014 on interventions to reduce the occurrence of SSIs (incisional infections and endometritis), among women undergoing C-section. We extracted data on the interventions, outcomes, and strength of evidence as determined by the original article authors, and assessed the quality of each article based on a modified Assessment of Multiple Systematic Reviews tool.

RESULTS

A total of 30 review articles met inclusion criteria and were reviewed. Among these articles, 77 distinct interventions were evaluated: 29% were supported with strong evidence as assessed by the original article authors, and 83% of the reviews articles were classified as good quality based on our assessment. Ten interventions were classified as being effective in reducing SSI with strong evidence in a good-quality article, including preoperative vaginal cleansing, the use of perioperative antibiotic prophylaxis, and several surgical techniques.

CONCLUSION

Efforts to reduce SSI rates among women undergoing C-section should include interventions such as preoperative vaginal cleansing and the use of perioperative antibiotics because compelling evidence exists to support their effectiveness.

Infect Control Hosp Epidemiol 2015;36(8):915–921

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Supplement 8 , August 2015 , pp. 915 - 921
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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