ArticleObstetrics and gynecology2019
Reducing Cesarean Delivery Surgical Site Infections: A Resident-Driven Quality Initiative.
Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Effectiveness of an evidence-based intervention bundle in reducing post-caesarean delivery surgical site infections: systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Prevalence of wound infections and related antimicrobial resistance in Goma, Democratic Republic of the Congo: a multicenter cross-sectional study.BMC infectious diseases · 2026Article
- Review
- Impact of Intraoperative Factors on the Development of Postpartum Septic Complications.Medicina (Kaunas, Lithuania) · 2023Article
- Article
- The Case for Standardizing Cesarean Delivery Technique: Seeing the Forest for the Trees.Obstetrics and gynecology · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo examine the association of a resident-driven quality initiative with cesarean delivery surgical site infections.
methodsThis was a quasi-experimental, preintervention and postintervention study of women undergoing cesarean delivery at 23 weeks of gestation or greater between January 2015 and June 2018 at a single tertiary care center. We implemented a resident-driven, evidence-based surgical bundle, excluding women who underwent emergency cesarean or had chorioamnionitis. The bundle included routine prophylactic antibiotics (both cefazolin and azithromycin), chlorhexidine alcohol skin preparation, use of clippers instead of a razor, vaginal cleansing with povidone iodine, placental removal by umbilical cord traction, subcutaneous tissue closure if wound thickness greater than 2 cm, suture skin closure, dressing removal between 24 and 48 hours, and use of postoperative chlorhexidine soap. Our primary outcome was surgical site infections (superficial incisional, deep incisional, and organ or space surgical site infections) occurring up to 6 weeks postpartum. Outcomes were compared between the preimplementation period (January 2015-August 2016) and postimplementation period (December 2016-June 2018). Coarsened Exact Matching with k-to-k solution was performed using age, race-ethnicity, body mass index, rupture of membranes, and labor.
resultsIn total, 1,624 underwent cesarean delivery in the preimplementation and 1,523 postimplementation periods, respectively; 1,100 women in the postimplementation period were matched to 1,100 women in the preimplementation period. The rate of surgical site infections in the unmatched cohort was significantly lower in the postimplementation period compared to those in the preimplementation period (2.2% [33/1,523] vs 4.5% [73/1,624]; odds ratio [OR] 0.47 [95% CI 0.31-0.71]; P<.001). This decrease in the rate of surgical site infections remained statistically significant after matching (1.9% [21/1,100] vs 4.1% [45/1,100]; OR 0.46 [0.27-0.77]; P<.001).
conclusionAfter implementation of a resident-driven quality initiative using a surgical bundle, we observed a significant decrease in cesarean surgical site infections.
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