Reducing Post-operative Infections in C-Sections With Caesarean section deliveries on the rise, more new mothers are at risk of surgical site infections. Some obstetricians are using an innovative new method to protect them. Rising rates of delivery by C-section In the past decade, the rate of C-section deliveries has increased steadily, reaching 24% in the United Kingdom [1] and 31% in the United States.[2] This makes C-section one of the more common surgeries, accounting for more than 1 million procedures annually in the United States alone. Some reports suggest that up to 2% of women delivered by C-section develop an SSI in hospital, and 7% more develop infections in the first 30 days after discharge [3,4]. Risk factors for SSIs after C-section Despite appropriate pre-surgical skin preparation and draping procedures, it is impossible to completely sterilize a patient’s skin.[5] Normal flora present on the patient’s skin are recognized by the Centers for Disease Control as a leading cause of SSIs.[6] An innovative approach being used by some obstetricians to help reduce the incidence of SSIs involves using surgical sealant to protect the incision site after pre-operative skin cleansing. Benefits of using surgical sealant Using a sealant such as Kimerly-Clark’s InteguSeal* Microbial Sealant has been shown to seal and immobilize pathogens that are left behind after typical pre-operative skin cleansing procedures.[5] InteguSeal* is a sterile, film-forming liquid that coats the skin surface, mechanically blocking pathogens from migrating into the incision.[7] Because the sealant is not an antibiotic itself, it does not promote bacterial resistance and can be effectively used to prevent infection by most common skin pathogens, including Methicillin-resistant Staphylococcus aureus (MRSA), S. epidermidis and E. coli. Recent study of Efficacy in C-section patients The effectiveness of InteguSeal* at reducing the rate of SSI infections after C-section delivery was recently evaluated at the McCord Hospital in Overport, South Africa.[8] From May 2007 to April 2009, all women undergoing C-section at the hospital (n=1,363) received InteguSeal* following typical pre-operative skin cleansing. The study findings showed that:[8] The incidence of hospital re-admissions due to SSIs dropped from 6.1% to 2.3% (p<0.0001) The risk of acquiring an SSI was almost 3 times greater in women in the non-sealant group (C-sections conducted prior to May 2007) The incidence of superficial and deep wound infections was lower in the sealant group (C-sections from May 2007 to April 2009) The McCord Hospital serves a high-risk patient population, with an HIV prevalence of 23% in antenatal women. [8] The risk of SSIs is more than double in these women compared to HIV-negative women, highlighting the effectiveness of InteguSeal* even in a higher risk population. This new barrier strategy has already been adopted by obstetricians in North America. Dr. Jacques Moritz, Director of Endoscopy Section and Division of Gynecology at St. Luke's-Roosevelt Hospital in New York City, uses InteguSeal* for C-section deliveries. Dr. Moritz says the barrier can be used in any type of surgery that penetrates the skin to reduce the risk of infection. InteguSeal* forms a protective layer that stays in place throughout the duration of the surgical procedure. After the completion of the C-section, the incision is closed and dressed according to hospital standards of care and removal of the sealant is not required. InteguSeal* naturally sloughs off the skin over the course of a few days, allowing new mothers to safely and comfortably recover at home and care for their new baby. For more information on prevention of surgical site infections and InteguSeal* Microbial Sealant, visit www.integuseal.com and www.HAIwatch.com/SSI. References [1] NHS Institute for Innovation and Improvement. Delivering quality and value. Focus on: Caesarean section. Coventry: NHS Institute for Innovation and Improvement; 2006. [2] U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics. National Vital Statistics Report. Vol. 57, No.7. January 7, 2009. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf. [3] Opøien HK, Valbø A, Grinde-Andersen A, Walberg M. Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study. Acta Obstet Gynecol Scand 2007;86(9):1097-1102. [4] Ward VP, Charlett A, Fagan J, Crawshaw SC. Enhanced surgical site infection surveillance following caesarean section: experience of a multicentre collaborative post-discharge system. J Hosp Infect 2008;70:166-73. [5] Wilson SE. Microbial sealing: a new approach to reducing contamination. J Hosp Infect 2008;70 (Suppl 2):11-14. [6] Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20(4):250-78. [7] Kimberly-Clark web site. Product Details: InteguSeal. Available at http://www.kchealthcare.com/integuseal/productDetails.aspx. Accessed December 14, 2009. [8] Coyle MJM. Reduction of SSI in Caesarean Section after integrating the use of a cyanoacrylate skin sealant into the preoperative skin prepping protocol. Poster presented at the XIX FIGO 2009 World Congress of Gynecology & Obstetrics, Cape Town, South Africa, 6 October 2009 (Presentation #P555). Kimberly-Clark Health Care, 1400 Holcomb Bridge Road, Roswell, Georgia 30076 Please click here to unsubscribe. Click here to Subscribe. Privacy Policy * Registered Trademark or Trademark of Kimberly-Clark Worldwide, Inc. ©2008 KCWW. 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