TY - JOUR
T1 - Infections complicating cesarean delivery
AU - Sood, Geeta
AU - Argani, Cynthia
AU - Ghanem, Khalil G.
AU - Perl, Trish M.
AU - Sheffield, Jeanne S.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose of review Cesarean sections are common surgical procedures performed in a healthy population and are unique because of a relatively high rate of postoperative infection. There have been many important advances in understanding the pathogenesis of infection and evaluation of interventions to prevent post cesarean section infections in the last few years. Our purpose in this review is to analyze these new data, discuss unanswered questions, and propose changes in standard of care. Recent findings Wound closure techniques including subcuticular sutures and subcutaneous suturing have been shown to be effective at reducing surgical site infections. Wound dressings including negative pressure dressings likely do not decrease infection rates. The type, timing, and duration of preoperative prophylactic antibiotics, including adjunctive azithromycin for laboring women and multidose antibiotics in obese women, have also yielded mixed results. Our understanding of normal uterine microbiome and the impact of intrapartum antibiotics on the newborn is emerging. Summary The pathogenesis of surgical site infections after Cesarean section is complex and multifactorial. Many interventions to reduce infections have been studied with varying degrees of effectiveness. Despite advances in the area, important questions remain unanswered.
AB - Purpose of review Cesarean sections are common surgical procedures performed in a healthy population and are unique because of a relatively high rate of postoperative infection. There have been many important advances in understanding the pathogenesis of infection and evaluation of interventions to prevent post cesarean section infections in the last few years. Our purpose in this review is to analyze these new data, discuss unanswered questions, and propose changes in standard of care. Recent findings Wound closure techniques including subcuticular sutures and subcutaneous suturing have been shown to be effective at reducing surgical site infections. Wound dressings including negative pressure dressings likely do not decrease infection rates. The type, timing, and duration of preoperative prophylactic antibiotics, including adjunctive azithromycin for laboring women and multidose antibiotics in obese women, have also yielded mixed results. Our understanding of normal uterine microbiome and the impact of intrapartum antibiotics on the newborn is emerging. Summary The pathogenesis of surgical site infections after Cesarean section is complex and multifactorial. Many interventions to reduce infections have been studied with varying degrees of effectiveness. Despite advances in the area, important questions remain unanswered.
KW - Cesarean section infections
KW - cesarean section infections
KW - pregnancy
KW - prophylaxis
KW - sepsis
UR - http://www.scopus.com/inward/record.url?scp=85049850127&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049850127&partnerID=8YFLogxK
U2 - 10.1097/QCO.0000000000000472
DO - 10.1097/QCO.0000000000000472
M3 - Review article
C2 - 29847329
AN - SCOPUS:85049850127
VL - 31
SP - 368
EP - 376
JO - Current Opinion in Infectious Diseases
JF - Current Opinion in Infectious Diseases
SN - 0951-7375
IS - 4
ER -