Major articleReduction of surgical site infections in low transverse cesarean section at a university hospital
Section snippets
Study method
We conducted an observational study to determine rates of SSI associated with LTCS and the impact of interventions at a 520-bed, academic teaching hospital performing an average of 550 LTCS surgical procedures annually. To identify rates of SSI associated with LTCS procedures, we obtained a list of the LTCS patients each month. Thirty days after each procedure, we reviewed all inpatient and outpatient electronic medical records and microbiologic reports for each LTCS patient to identify cases
Results
From October 2005 to December 2008, 1,844 LTCS procedures were performed. Of these, 99 patients were identified with SSI, including 44 (44.4%) superficial infections, 11 (11.1%) deep incision infections, and 44 (44.4%) organ spaces infections (endometritis). Twelve wound cultures (12.1%) were obtained from the 99 SSI cases. The most frequent isolates were Enterococcus spp (67%), coagulase-negative staphylococci (44%), Corynebacterium spp (44%), and Proteus spp (33%).
From October 2005 to March
Discussion
We utilized a multidisciplinary approach to reduce LTCS SSI rates 63.5% over a 39-month period by identifying critical control points, developing an action plan, implementing evidence-based SSI prevention recommendations, improving practices, providing timely feedback of SSI rates and compliance with performance measures to the OBGYN clinicians, and continuous evaluation of the SSI prevention program. Of note, the proportion of patients in NNIS risk categories 2 and 3 increased during the
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Conflicts of interest: None to report.