Careful surgical technique can reduce infectious morbidity after cesarean section

A total of 635 consecutive cesarean sections performed in private practices during the past 20 years are reviewed. In the course of this 20 year period, we have tried to alter gradually our surgical technique used for this procedure to conform to the principles of surgery developed by Halsted. The study is divided into three periods of time to examine the results of changes in technique. With the use of the standard definition of febrile morbidity (temperature of greater than or equal to 100.4 degrees F during any two 24-hour periods after the first postoperative 24 hours) the postoperative morbidity rate was 15% during 1967 to 1973, 5.4% during 1974 to 1979, and 0.7% during the period 1980 through 1986. Prophylactic antibiotics were used with decreasing frequency. It was clear that the reduction in morbidity was the result of the modifications in surgical technique.