Reducing Surgical Site Infection in Caesarean Sections

What are the causes of C-Section wound infections?

Several factors are contributing to the rise in caesarean births, including increasing maternal age, more complex health needs and evolving patient choice.

Certain factors drive the likelihood of developing a post-c-section surgical site infection (SSI), among them are:

• maternal obesity
• hypertensive disorders
• smoking
• multiple vaginal examinations prior to giving birth
• an emergency c-section
• giving birth in a lower income country – which is one of the greatest risk factors.

One in four pregnant women in England is now living with obesity, increasing the likelihood of complications and caesarean delivery [3].

The number of women experiencing a post-c-section SSI is likely to increase globally, mainly due to the overall rising number of c-sections in recent and coming years.

Why this matters: rising infection risk

As caesarean section rates increase, so too does the risk of SSI, the most frequently reported complication following surgery [4].

In England, up to 16% of women giving birth by C-section may experience a surgical site infection, many of which develop after discharge [6].

With infection risk increasing alongside rising surgical intervention, prevention is more important than ever.

How to avoid a C-Section wound infection

With infection risk increasing, effective prevention strategies are critical to reducing post-C-section SSIs.

Effective infection prevention strategies need to be implemented in hospitals to minimize post-c-section SSIs.

Up to 60% of surgical site infections are considered preventable when evidence-based approaches are used [7].

A recent initiative in six hospitals in the West England region aims to reduce post-c-section SSIs by implementing an effective infection prevention bundle based on WHO and NICE recommendations [6].

This bundle consists of

• alcoholic skin preparation
• the use of a dual ring wound protector for mothers with a BMI > 45
• repeated doses of antibiotics in case of excess blood loss
• and antibacterial suture.

Evidence-based approaches - including preoperative skin cleansing and antimicrobial washing - have been shown to significantly reduce infection risk [8].

Yet, mothers should not only rely on the hospitals to take action, there are some things that they can do themselves to minimize the risk of any post-c-section surgical site infection.

Prior to c-section:

• Shower with soap and water before you come to hospital.
• Do not shave the area of the procedure with a razor up to 24 hours before your delivery, as this increases the risk of an infection.
• Keep yourself warm before and after your arrival in the hospital.

After your c-section:

• Shower as soon as you feel able to, but don’t use soap or other hygiene products on your wound.
• Always wash your hands before touching the wound.
• If your stomach covers your wound, lift it gently and wash the area with clear water.
• Dry the wound by gently patting it with a clean towel – don’t rub it.
• Wear loose fitting, high waisted underwear to prevent pressure on the wound.