Background
Surgical site infection (SSI) is an important complication of cesarean section (CS)
delivery and a key quality indicator of patient care.
Methods
A baseline assessment was undertaken to determine SSI rates, and subsequently a quality
improvement program was introduced, followed by repeat surveillance. Data were collected
during in-hospital stays and for up to 30 days after CS during both periods. Interventions
in the quality improvement program included the use of nonabsorbable sutures for skin
closure, use of clippers instead of razors, and use of 2% ChloraPrep for skin disinfection
before incision.
Results
A total of 710 patients were surveyed before the interventions, and 824 patients were
surveyed after the interventions. Of these, 114 (16%) had an SSI before the interventions,
and 40 (4.9%) had an SSI after the interventions (P < .001; odds ratio, 0.27), with 90% and 83%, respectively, detected after hospital
discharge. In multivariate analysis, obesity (P = .002) and the use of absorbable suture materials for skin closure (P = .008) were significantly associated with a higher SSI rate before the interventions;
however, only obesity was associated with a higher SSI rate after the quality program.
Conclusion
Surveillance of SSI rates after CS followed by 3 interventions contributed to a significant
reduction in SSI rate and improved patient care.
Key Words
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Article info
Publication history
Published online: August 12, 2013
Footnotes
Conflicts of interest: Iskus Health supplied the ChloraPrep and disposable clippers used in this study. The authors report no conflicts of interest.
Identification
Copyright
© 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
