Comparing Postcesarean Infectious Complication Rates Using Two Different Skin Preparations

Weed, Samantha; Bastek, Jamie A.; Sammel, Mary D.; Beshara, Mathew; Hoffman, Stacey; Srinivas, Sindhu K.

doi:10.1097/aog.0b013e3182118e98

Cited by 12 publications

(3 citation statements)

References 18 publications

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“…An example is surgical site infections, which are affected by preoperative antibiotics and the abdominal preparatory process. 4 Process measures assess how the care system acts and do not assess the results of the care. Process measures are popular because they reflect actions of the care system and thus are able to be directly influenced by the health system.…”

Section: Current Measures Of Obstetrical Qualitymentioning

confidence: 99%

Society for Maternal-Fetal Medicine (SMFM) Special Report: Current approaches to measuring quality of care in obstetrics

Bailit

Gregory

Srinivas

et al. 2016

American Journal of Obstetrics and Gynecology

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Heath care measurement and evaluation is an integral piece of the health care system. The creation and assessment of care performance metrics are important and relevant for the obstetric community including both clinicians and patients. Careful deliberation is required to create a measurement system that results in optimal care for women and families. This article reviews the current approaches to measuring quality in obstetrics.

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Section: Current Measures Of Obstetrical Qualitymentioning

confidence: 99%

Society for Maternal-Fetal Medicine (SMFM) Special Report: Current approaches to measuring quality of care in obstetrics

Bailit

Gregory

Srinivas

et al. 2016

American Journal of Obstetrics and Gynecology

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“…These statistics have prompted investigation into the short- and long-term impact of cesarean delivery on fetal and maternal outcomes (3–5). Post-operative complication rates for both primary and repeat cesarean delivery vary widely and are reported anywhere from 5 to 35% (6–14). The most common causes of maternal peri-operative morbidity associated with cesarean delivery include surgical site infection and wound complications, hemorrhage, bowel/bladder injury and obstruction, and thromboembolic complications.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and short-term safety of modified sodium hyaluronic acid-carboxymethylcellulose at cesarean delivery: a randomized trial

Kiefer

Muscat

Santorelli

et al. 2016

American Journal of Obstetrics and Gynecology

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Background The rising cesarean birth rate has drawn attention to risks associated with repeat cesarean birth. Prevention of adhesions with adhesion barriers has been promoted as a way to decrease operative difficulty. However, robust data demonstrating effectiveness of such interventions are lacking. Objective We report data from a multicenter trial designed to evaluate the short-term safety and effectiveness of a modified sodium hyaluronate-carboxymethylcellulose absorbable (HACMC) for reduction of adhesions following cesarean delivery. Methods Patients that underwent primary or repeat cesarean delivery were included in this multicenter, single-blinded (patient), randomized controlled trial. Patients were randomized into either HA-CMC (N=380) or no-treatment group (N=373). No other modifications to their treatment were part of the protocol. Short-term safety data was collected following randomization. The location and density of adhesions (primary outcome) were assessed at their subsequent delivery using a validated tool, which can also be used to derive an adhesion score, that ranges from 0–12. Results No differences in baseline characteristics, post-operative course, or incidence of complications between the groups following randomization were noted. Eighty patients from the HA-CMC group and 92 controls returned for subsequent deliveries. Adhesions in any location were reported in 75.6% of the HA-CMC group and 75.9% of the controls (P=0.99). There was no significant difference in the median adhesion score; 2 (range 0–10) for the HACMC group vs. 2 (range 0–8) for the control group (P=0.65). One third of the HA-CMC patients met the definition for severe adhesions (adhesion score >4) compared to 15.5% in the control group (P=0.052). There were no significant differences in the time from incision to delivery (P=0.56). Uterine dehiscence in the next pregnancy was reported in 2 patients in HA-CMC group versus 1 in the control (P=0.60). Conclusions Although we did not identify any short-term safety concerns, HA-CMC adhesion barrier applied at cesarean delivery did not reduce adhesion formation at the subsequent cesarean delivery.

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“…A recent retrospective cohort study comparing the traditional iodine paint technique to a protocol using a 3-minute iodine scrub in addition to the standard paint technique demonstrated that a scrub and paint preparation was associated with a decrease in the rate of postcesarean delivery infectious complications, such as endometritis, sepsis, cellulitis, peritonitis, and salpingitis, compared to the paint technique alone. 10 A major limitation of this study, however, is that not all patients received cefazolin prophylaxis preoperatively, a current standard practice described below. More patients in the ''Scrub and Paint'' group in the study, in fact, received antimicrobial prophylaxis.…”

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confidence: 99%

Cesarean Delivery Technique

Encarnacion

Zlatnik²

2012

Obstetrical &Amp; Gynecological Survey

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Cesarean delivery is the most common surgical procedure performed in the United States, yet the techniques used during this procedure often vary significantly among providers. The purpose of this review was to evaluate and outline current evidence behind the cesarean delivery technique. A search of the PubMed database was conducted using the terms cesarean section and cesarean delivery and the technique of interest, for example, cesarean section prophylactic antibiotics. Few aspects of the cesarean delivery were found to have high-quality consistent evidence to support use of a particular technique. Because many aspects of the procedure are based on limited or no data, more studies on specific cesarean delivery techniques are clearly needed. Providers should be aware of which components of the cesarean delivery are evidence-based versus not when performing this procedure.

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Comparing Postcesarean Infectious Complication Rates Using Two Different Skin Preparations

Abstract: The SCRUB+PAINT protocol is associated with a decrease in the rate of postcesarean delivery infectious complications compared with using povidone-iodine topical paint alone.

Cited by 12 publications

References 18 publications

Society for Maternal-Fetal Medicine (SMFM) Special Report: Current approaches to measuring quality of care in obstetrics

Society for Maternal-Fetal Medicine (SMFM) Special Report: Current approaches to measuring quality of care in obstetrics

Effectiveness and short-term safety of modified sodium hyaluronic acid-carboxymethylcellulose at cesarean delivery: a randomized trial

Cesarean Delivery Technique

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