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. 2023 Sep 10;59(9):1637.
doi: 10.3390/medicina59091637.

Impact of Intraoperative Factors on the Development of Postpartum Septic Complications

Diana Andzane  1   2   3   4 , Anna Miskova  1   3   4 , Antra Krone  1 , Dace Rezeberga  1   2   3
Affiliations

Impact of Intraoperative Factors on the Development of Postpartum Septic Complications

Diana Andzane et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Triclosan-coated sutures (antibacterial sutures) can reduce the risk of postoperative surgical site infection. This study aimed to investigate the effect of intraoperative factors, including antibacterial sutures, on the risk of postpartum septic complications. Materials and Methods: The prospective study included patients who underwent caesarean section. The exclusion criterion was chorioamnionitis. The investigation group patient's (n = 67) uterus and fascial sheath of the abdominal wall were sutured with triclosan-coated polyglactin 910 sutures during surgery. The control group consisted of 98 patients using uncoated polyglactin 910 sutures only. The patients were contacted by phone after the 30th postoperative day. Results: No significant difference was found between the investigation group and the control group in the development of postpartum endometritis (11.7% in the investigation group vs. 8.4% in the control group, p = 0.401), wound infection (6.3% vs. 3.6%, p = 0.444) or patients experienced any septic complication (15.9% vs. 12%, p = 0.506). Postpartum endometritis was more common in patients who underwent instrumental uterine examination during the surgery (23.8% vs. 18%, p = 0.043). A moderately strong correlation was found for haemoglobin level on the third-fourth postoperative day with the development of postpartum septic complications, p < 0.001, Pearson coefficient -0.319. Post-caesarean delivery septic complications were not statistically more common in patients with blood loss greater than 1 L. The incidence of post-caesarean endometritis was 13.4%, and wound infection was 4.8% in this study's hospital, having five to six thousand deliveries per year. Conclusions: Using antibacterial sutures during caesarean section does not affect the incidence of postpartum septic complications. Instrumental uterine examination during caesarean section increases the risk of post-caesarean endometritis and is, therefore, not recommended. Haemoglobin level on the 3rd-4th postoperative day, rather than the estimated blood loss during surgery, affects the development of postpartum septic complications.

Keywords: antibacterial sutures; caesarean section; postpartum endometritis; triclosan.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Risk factors for postpartum septic complications.
Figure 2
Figure 2
Flowchart of this study’s population.
Figure 3
Figure 3
The investigation and control group patients were distributed by caesarean section category, p = 0.057.
Figure 4
Figure 4
Haemoglobin level on post-surgical day 3–4 in patients with and without septic complications; p < 0.001; Pearson coefficient −0.319.
Figure 5
Figure 5
The relationship between suturing of the parietal peritoneum and pain on the 1st postoperative day, p = 0.047, Pearson’s coefficient 0.155.
Figure 6
Figure 6
The frequency of development of postpartum septic complications according to the degree of urgency of caesarean section.
See this image and copyright information in PMC

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References

    1. Tuuli M.G., Stout M.J., Martin S., Rampersad R.M., Cahill A.G., Macones G.A. Comparison of Suture Materials for Subcuticular Skin Closure at Cesarean Delivery. Am. J. Obstet. Gynecol. 2016;215:490.e1–490.e5. doi: 10.1016/j.ajog.2016.05.012. - DOI - PubMed
    1. Poggi S.B.H. Postpartum Hemorrhage & Abnormal Puerperium. In: DeCherney A.H., Nathan L., Laufer N., Roman A.S., editors. CURRENT Diagnosis & Treatment: Obstetrics & Gynecology. 12th ed. McGraw-Hill Education; New York, NY, USA: 2019.
    1. Kawakita T., Landy H.J. Surgical Site Infections after Cesarean Delivery: Epidemiology, Prevention and Treatment. Matern. Health Neonatol. Perinatol. 2017;3:12. doi: 10.1186/s40748-017-0051-3. - DOI - PMC - PubMed
    1. Taylor M., Pillarisetty L.S. Endometritis. Br. Med. J. 2022;1:818–821. doi: 10.1136/bmj.1.1322.818. - DOI
    1. Karsnitz D.B. Puerperal Infections of the Genital Tract: A Clinical Review. J. Midwifery Womens Health. 2013;58:632–642. doi: 10.1111/jmwh.12119. - DOI - PubMed

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