Reducing surgical site infection following caesarean section

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Surgical Site Infection Control

Background:

• Surgical site infections (SSIs) following caesarean sections pose a significant risk to maternal health.
• Establishing benchmark infection rates is crucial for monitoring and improving healthcare quality.
• National Institute for Health and Clinical Excellence (NICE) provides guidelines to mitigate SSIs.

Purpose of the Study:

• To establish a benchmark surgical site infection (SSI) rate for caesarean sections.
• To reduce SSI rates by monitoring and implementing NICE guidelines.
• To evaluate the efficacy of specific dressings in conjunction with guidelines.

Main Methods:

• A two-year prospective study monitored 2382 caesarean section patients across two hospital sites.
• An infection surveillance system tracked infections during hospitalization, with community midwives collecting post-discharge data.
• Patient-reported outcomes were gathered via 30-day post-operative questionnaires. Compliance with NICE guidance was assessed and interventions were applied.

Main Results:

• Pre-guideline SSI rates ranged from 5.7% to 9.0%.
• Following guideline implementation, SSI rates decreased by 3.3% at site A and 3.8% at site B.
• The introduction of a hydrofiber and hydrocolloid dressing further reduced SSI rates to 1.3% at site A.

Conclusions:

• The combination of NICE guidance and hydrofiber/hydrocolloid dressings effectively reduces SSI rates post-caesarean section.
• This strategy aids in establishing and achieving lower benchmark SSI rates.
• Evidence supports the use of advanced wound dressings as part of SSI prevention protocols.