Zuarez-Easton Sivan, Zafran Noah, Garmi Gali, Salim Raed
Department of Obstetrics and Gynecology, Emek Medical Center, Afula.
Department of Obstetrics and Gynecology, Emek Medical Center, Afula; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Int J Womens Health. 2017 Feb 17;9:81-88. doi: 10.2147/IJWH.S98876. eCollection 2017.
Surgical site infection (SSI) is one of the most common complications following cesarean section, and has an incidence of 3%-15%. It places physical and emotional burdens on the mother herself and a significant financial burden on the health care system. Moreover, SSI is associated with a maternal mortality rate of up to 3%. With the global increase in cesarean section rate, it is expected that the occurrence of SSI will increase in parallel, hence its clinical significance. Given its substantial implications, recognizing the consequences and developing strategies to diagnose, prevent, and treat SSI are essential for reducing postcesarean morbidity and mortality. Optimization of maternal comorbidities, appropriate antibiotic prophylaxis, and evidence-based surgical techniques are some of the practices proven to be effective in reducing the incidence of SSI. In this review, we describe the biological mechanism of SSI and risk factors for its occurrence and summarize recent key clinical trials investigating preoperative, intraoperative, and postoperative practices to reduce SSI incidence. It is prudent that the surgical team who perform cesarean sections be familiar with these practices and apply them as needed to minimize maternal morbidity and mortality related to SSI.
手术部位感染（SSI）是剖宫产术后最常见的并发症之一，发病率为3%-15%。它给产妇本人带来身体和精神负担，也给医疗保健系统造成巨大经济负担。此外，SSI与高达3%的孕产妇死亡率相关。随着全球剖宫产率的上升，预计SSI的发生率也将随之增加，因此其具有重要的临床意义。鉴于其重大影响，认识到其后果并制定诊断、预防和治疗SSI的策略对于降低剖宫产术后发病率和死亡率至关重要。优化产妇合并症、合理使用抗生素预防以及采用循证手术技术是已被证明有效降低SSI发生率的一些做法。在本综述中，我们描述了SSI的生物学机制及其发生的危险因素，并总结了近期研究术前、术中和术后降低SSI发生率做法的关键临床试验。进行剖宫产手术的外科团队熟悉这些做法并根据需要加以应用，以尽量减少与SSI相关的产妇发病率和死亡率，这是明智之举。
