McKibben et al identified risk factors associated with cesarea section surgical site infection. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Johns Hopkins University.
Patient selection: woman delivering by cesarean section
Risk Factor
Intervention
skin preparation
protocol with optimum skin cleansing
hair removal
minimize skin trauma
vaginal flora
preoperative varginal cleansing
remote infection
treat remote infection
Staphylococcus colonization
screen for and treat colonization
diabetes mellitus
perioperative glucose control
emergency C-section
protocol to optimize skin preparation prior to surgery
hypothermia during the procedure
maintain normothermia
lapses in surgical technique
train and manage personnel
surgical environment (hot, etc)
optimize environment
bacterial flora
antibiotic prophylaxis
Patient-specific risk factors:
(1) pre-eclampsia
(2) obesity
(3) low socioeconomic group
(4) little or no prenatal care
(5) nulliparity
(6) high risk racial or social group
(7) smoking
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