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Table 2 Interventions and techniques surrounding cesarean delivery

From: Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

 

Wound infection

Endometritis

Variables

RR or OR

References

RR or OR

References

Preoperative elements

 First generation cephalosporin vs. none

0.38

34

0.42

34

 First generation cephalosporin prior to skin incision vs. after cord clamp

0.7

11, 35-38

0.21-0.61

11, 35-38

 First generation cephalosporin 2 g vs. 3 g in morbidly obese women

NS

40

-

-

 Azithromycin

  In labor

0.35

9

0.62

9

  Non labor

-

-

0.11

41

 Chlorhexidine alcohol skin preparation vs. iodine

0.55

42, 43

NS

42

 Razor hair removal vs. clippers

2.1

44

-

-

 Vaginal cleansing

  Chlorhexidine vs none

NS

45

0.2

45

  Iodine vs none

NS

10, 18, 46, 47

0.39

10, 18, 46, 47

   In labor

NS

47

NS

47

   Not in labor

NS

47

NS

47

   Ruptured membranes

NS

46, 47

0.13

46, 47

   Intact membranes

NS

47

NS

47

Intraoperative elements

 Uterine exteriorization

NS

49

NS

49

 Manual removal of placneta vs. traction of umbilical cord

-

-

1.4-1.6

50, 51

 Intraabdominal irrigation

NS

53

NS

52, 53

 Closure of subcutaneous tissue if >2 cma

NS

54

-

-

 Subcutaneous drain

NS

55, 56

-

-

 Suture skin closure vs. stapleb

NS

6, 57, 58

-

-

Postoperative elements

 Dressing removal between 24 and 48 h vs. 6 h

NS

7

-

-

  1. RR relative risk; OR odds ratio; NS not statistically significant; CI confidence interval
  2. aWound complications (hematoma, seroma, and infection) - RR 0.66; 95%CI 0.48, 0.91; Wound separation - RR 0.42; 95%CI 0.24, 0.75
  3. bWound complications (wound infection, hematoma, seroma, or separation of 1 cm or longer) -adjusted OR 0.43; 95%CI 0.23, 0.78; wound separation - adjusted OR 0.20; 95%CI 0.07, 0.51