Surgical Site Infection Clinical Trial
Official title:
Preoperative Chlorhexidine Cloths to Reduce Surgical Site Infection in Non-Scheduled Cesarean Deliveries
Pregnancy-associated infection represents a major cause of maternal morbidity and mortality.
Cesarean delivery is the most common major surgical procedure and is associated with a rate
of surgical site infection (SSI) that is approximately 5-10 times the rate for vaginal
delivery. Efforts to reduce the risk of SSIs in this patient population include the use of
preoperative antibiotic prophylaxis in addition to skin and vaginal antiseptic
preparations.Nevertheless, the rate of SSI in women undergoing non-scheduled cesarean
delivery is up to 18%, a significant number that contributes to prolonged hospital stays and
increased health care costs.
Every effort should be made to reduce this major cause of pregnancy-associated morbidity and
mortality to aid in the care of patients and reduce the associated prolonged hospital stays,
readmission rates and health care costs. Studies have shown that preoperative application of
chlorhexidine cloths reduces the risk of SSI, however this is based on literature in the
orthopedic and intensive care patients. The efficacy of this intervention has not been
studied in obstetric patients undergoing cesarean delivery. Furthermore, obstetric patients
undergoing non-scheduled cesarean delivery represent a target population as it is thought
that infectious morbidity is higher in this patient population. Therefore, there is a need
for this trial to determine if this intervention is effective in reducing the rate of
postoperative SSIs.
This randomized clinical trial will be investigating the use of preoperative chlorhexidine cloths, a chemical skin antiseptic agent effective on gram positive and gram negative bacteria, as an intervention to reduce the rate of surgical site infections (SSIs). The intervention group will be women undergoing non-scheduled cesarean delivery randomized to receive preoperative abdominal application of 2% chlorhexidine cloths. The control group will be women undergoing non-scheduled cesarean delivery randomized to receive standard preoperative care. The impact on women's health is significant, as a reduction in SSIs in this prevalent patient population can reduce the number of prolonged hospital stays, outpatient follow-ups for infection, hospital readmissions and health care costs. ;
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