Post caesarian section surgical site infections. Review of current literature

Abstract

Caesarean delivery rates have increased globally during the past three decades. Caesarean delivery is the most important obstetrical procedure performed with complications that consist of postpartum hemorrhage, endometritis, thromboembolic events or incision infections. While surgical site infections (SSIs) complicate 1.9% of all surgeries performed, the incidence of SSIs after caesarean delivery is significantly higher, almost 7-10%, constituting an important cause of increased morbidity, mortality, readmission, prolonged hospitalization and increased health care costs worldwide. Incisional infection after caesarean delivery happens in 2-7% of cases, necrotizing fasciitis in 0.18% and endometritis in 2-16%. Many risk factors for SSIs have been described. This review includes the several risk factors that have been identified in women who developed post-caesarean section surgical site infections. We also provide an overview of strategies for prevention of postoperative infections including antibiotic prophylaxis, surgical techniques, management of wound infections. Criteria of diagnosis for SSIs are also given, as well as current treatment regimens. Given the impact of maternal post-caesarean infection, it is important for gynecologists to understand how to prevent these postoperative infections, as well as recognize and treat them.