Preoperative vaginal preparation reduces postoperative systemic infectious complications in gynecologic surgery: a propensity score-matched retrospective cohort study.

Xiaojia Zheng, Liping Xu, Jin Peng, Qun Sun, Minhong Cai, Jing Chen, Pingping Wang, Yajun Bai, Qian Xiang

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Article in Frontiers in cellular and infection microbiology, 2026. 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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9 authors.

Xiaojia Zheng *Healthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Liping Xu *Hospital Infection Control Department, Sichuan Provincial People's Hospital Pujiang Hospital-Pujiang People's Hospital, Chengdu, Sichuan, China.

Jin Peng *Hospital Infection Control Department, Sichuan Provincial People's Hospital East Sichuan Hospital & Dazhou First People's Hospital, Dazhou, Sichuan, China.

Qun SunChengdu Institute of Food Inspection; Irradiation Preservation Key Laboratory of Sichuan Province, Chengdu, China.

Minhong CaiHealthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Jing ChenHealthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Pingping WangHealthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Yajun BaiDepartment of Healthcare-associated Infection Management, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan, China.

Qian XiangHealthcare-associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postoperative systemic infectious complications (PSIC) impose a substantial burden on clinical resources following gynecologic surgery. While international guidelines recommend preoperative vaginal preparation, high-quality evidence supporting its efficacy against PSIC remains limited. Furthermore, uptake varies widely in practice, often reflecting healthcare reform priorities such as Diagnosis-Related Groups (DRG) and Diagnosis-Intervention Packet (DIP). Methods: We conducted a retrospective cohort study of 17,582 gynecologic surgery patients (January 2022-December 2024) at a southwestern Chinese tertiary hospital. Propensity score matching (PSM) produced 2,195 balanced pairs. The study outcome was the incidence of PSIC, assessed using an objective, EMR-based algorithmic definition. Results: Vaginal preparation reduced PSIC incidence by nearly half (1.28% vs. 2.19%; adjusted OR = 0.623, 95% CI: 0.385-0.919, p = 0.040). The protective effect was robust across pre-specified subgroups, with marked risk reductions observed among patients undergoing open surgery, those using prophylactic antibiotics, anemic patients, and non-diabetics. Conclusions: Preoperative vaginal preparation reduced PSIC risk in this real-world cohort. This intervention proved particularly valuable for specific patient and procedural subgroups. As a cost-effective measure, it warrants inclusion in routine preoperative protocols, even within efficiency-driven frameworks such as Enhanced Recovery After Surgery (ERAS) and DRG/DIP.

Indexed as

Gynecologic Surgical ProceduresPostoperative ComplicationsPreoperative CareVaginaAdultAgedChinaFemaleHumansIncidenceMiddle AgedPropensity ScoreRetrospective Studiesdoubly robust estimationgynecological surgerypropensity score matchingsystemic infectious complicationsvaginal preparation

Identifiers

PMID42694126

DOI10.3389/fcimb.2026.1847878

PMCPMC13537965

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