Effect of chlorhexidine skin prep and subcuticular skin closure on post-operative infectious morbidity and wound complications following cesarean section
| Autor: | Gideon Zamba, Abbey J Hardy-Fairbanks, Anna M. Button, Sara Tikkanen |
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| Rok vydání: | 2013 |
| Předmět: |
History
medicine.medical_specialty education.field_of_study integumentary system business.industry Population Chlorhexidine Statistical difference Intervention group Computer Science Applications Education Surgery Suture (anatomy) Anesthesia medicine Significant risk Subcuticular suture Post operative education business medicine.drug |
| Zdroj: | Proceedings in Obstetrics and Gynecology. 3:1-10 |
| ISSN: | 2154-4751 |
| Popis: | Background: The obstetrical department at University of Iowa implemented several interventions at reducing post-operative infections and wound complication rates following a cesarean delivery. We implemented subcuticular closure of the skin following all cesarean sections in February of 2011 and switched from a povidone/iodine skin prep to a chlorhexidine-alcohol prep April 19th 2011. Based on prior studies, we hypothesized a 50% reduction in post cesarean wound complications Objective: To determine if changes in skin prep type and closure method decreases post-operative infectious morbidity and wound complications. Methods: The study reviewed charts of women who underwent a cesarean section between 7/1/2010 and 12/31/2010 compared to those that underwent a cesarean section between 4/19/2011 and 9/7/2011. A total of 568 charts were reviewed. Women were divided into two groups; the control group included those who had a povidone/iodine skin prep and staple closure, the intervention group included those women who had chlorhexidine skin prep and skin closure with subcuticular suture. Results: A total of 568 charts were reviewed and 190 control (iodine/staples) subjects and 139 intervention (chlorhexidine-alcohol/suture) subjects were identified. We found no statistical difference in the overall wound complication rates between the control and intervention groups, 22.1% vs 17.4% (p.22). We did however find a significant decrease in wound separation rates: 8.4% vs 3% (p.014) Analysis showed significant risk factors for infectious morbidity and wound separation to be labor prior to surgery (p Conclusion: In our population the implementation of a chlorhexidine skin prep and closure of the skin with a subcuticular suture did not decrease overall infectious morbidity, it did however decrease our wound separation rate. |
| Databáze: | OpenAIRE |
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