Evidence map›Paper›PMID 41436971›Full record

SynthesisBMC pregnancy and childbirth2025

Effectiveness of an evidence-based intervention bundle in reducing post-caesarean delivery surgical site infections: systematic review and meta-analysis.

Tirusew Nigussie Kebede, Kidist Ayalew Abebe, Birhan Tsegaw Taye, Tenaw Belay Shitie, Agmuas Asichale Alimawu, Molla Amsalu Tadesse, Tebabere Moltot, Moges Sisay Chekole, Solomon Hailemeskel Beshah

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Tirusew Nigussie KebedeDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia. tirusew1221@gmail.com.
Kidist Ayalew AbebeDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia.
Birhan Tsegaw TayeDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia.
Tenaw Belay ShitieDepartment of Pediatrics Nursing, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
Agmuas Asichale AlimawuDepartment of Anesthesia, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
Molla Amsalu TadesseDepartment of Anesthesia, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
Tebabere MoltotDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia.
Moges Sisay ChekoleDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia.
Solomon Hailemeskel BeshahDepartment of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O.BOX: 445, Debre Berhan, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCaesarean section (CS) is among the most frequently performed surgical procedures worldwide and is critical for reducing maternal and neonatal mortality. However, surgical site infections (SSIs) remain one of the most common postoperative complications, imposing substantial maternal morbidity, delaying recovery, and indirectly affecting neonatal health. Despite various infection prevention measures, the burden of SSIs is particularly high in low- and middle-income countries (LMICs). Emerging evidence suggests that implementing evidence-based care bundles can markedly reduce SSIs, but existing studies are fragmented and inconsistent, underscoring the need for a comprehensive synthesis.

objectiveTo evaluate the effectiveness of evidence-based care bundles in preventing SSIs following caesarean delivery.

methodsThis systematic review and meta-analysis followed PRISMA 2020 guidelines (PROSPERO registration: CRD42024603854). A comprehensive search was conducted in PubMed, Cochrane Library, Scopus, Hinari, and Google Scholar using a PICO-based strategy. Eligible studies were critically appraised using the revised Joanna Briggs Institute (JBI) tools. Heterogeneity was assessed using the Galbraith plot, I² statistics, and Cochran's Q test. Publication bias was examined with funnel plots and Egger's test. A fixed-effects model was applied to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs).

resultsA total of 21 studies involving 32,709 women who underwent CS were included. Pooled analysis demonstrated that implementation of evidence-based intervention bundles significantly reduced the incidence of post-CS SSIs from 5% (95% CI: 1-8%) before intervention to nearly 0% (95% CI: 0-1%) after intervention (RR: 0.29, 95% CI: 0.27-0.31). This represents a 71% relative reduction in SSI risk. In absolute terms, bundle implementation translated into thousands of preventable infections and avoided complications across diverse settings.

conclusionEvidence-based bundles are a highly effective, practical, and adaptable strategy for reducing SSIs following caesarean delivery. Their integration into routine obstetric care can substantially improve maternal recovery, support early neonatal care including breastfeeding, and decrease healthcare costs associated with prolonged hospital stays. Adoption of such bundles should be prioritized globally, with particular urgency in LMICs where the burden of post-CS SSIs is highest.

Indexed as

Cesarean SectionPatient Care BundlesSurgical Wound InfectionEvidence-Based MedicineFemaleHumansPregnancyCaesarean deliveryEvidence-Based bundleInfection preventionSurgical site infection

Identifiers

PMID41436971
PMCPMC12836906

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.