Myers Garrison, Coutinho Marissa M, Huckaby Alicia, Maloy Katie, Buderer Nancy
Department of Obstetrics and Gynecology, Mercy Health St. Vincent Medical Center, Toledo, USA.
Department of Statistics, Nancy Buderer Consulting, LLC, Toledo, USA.
Cureus. 2025 Mar 15;17(3):e80615. doi: 10.7759/cureus.80615. eCollection 2025 Mar.
To determine if the use of 0.05% chlorhexidine gluconate (CHG) irrigation solution during cesarean delivery (CD) can reduce the post-cesarean surgical site infection (SSI) rate when compared to standard practices without CHG irrigation.
A single-center retrospective observational study was performed at a community hospital in Toledo, Ohio. Control and treatment periods were defined, and patients in the treatment group received irrigation with CHG solution during CD, while the control group did not. An electronic medical record review was conducted to note additional perioperative procedures that affect SSI rates. Patients were evaluated for infection at standard postoperative appointments using the CDC criteria, and the hospital system's department of infection prevention provided records of all documented SSIs in both groups. Characteristics of the deliveries and SSIs of each group were compared using the chi-square or Fisher's exact two-tailed tests.
Data were available for 351 deliveries after the implementation of the CHG protocol, and 432 deliveries were used as the control group. No significant difference in rates of infection was found between the two groups (p = 0.68). There were significantly more endometritis infections diagnosed in the treatment group compared to the control group (four (1.1%) versus zero; p = 0.04). Compared to the controls, the treatment group had fewer deliveries with the use of silver dressing, more deliveries with a negative pressure dressing, and more deliveries with a diagnosis of pregestational or gestational diabetes (p < 0.05). There were no other differences between the groups, including the use of abdominal and vaginal prep, BMI > 35, and perioperative antibiotics.
This single center retrospective observational study revealed no difference in post-cesarean SSI rates when performing intra-abdominal and subcutaneous irrigation with CHG solution. A significant increase in endometritis was observed with the use of CHG irrigation; however, further studies are required to determine the benefit or harm of antimicrobial irrigation in CDs.
确定剖宫产（CD）期间使用0.05%葡萄糖酸氯己定（CHG）冲洗液与不使用CHG冲洗的标准做法相比，是否能降低剖宫产术后手术部位感染（SSI）率。
在俄亥俄州托莱多的一家社区医院进行了一项单中心回顾性观察研究。定义了对照期和治疗期，治疗组患者在剖宫产期间接受CHG溶液冲洗，而对照组未接受。进行电子病历审查以记录影响SSI率的其他围手术期程序。使用美国疾病控制与预防中心（CDC）标准在标准术后预约时对患者进行感染评估，医院系统的感染预防部门提供两组所有记录在案的SSI记录。使用卡方检验或Fisher精确双侧检验比较每组分娩和SSI的特征。
实施CHG方案后有351例分娩的数据可用，432例分娩用作对照组。两组之间的感染率没有显著差异（p = 0.68）。与对照组相比，治疗组诊断出的子宫内膜炎感染明显更多（4例（1.1%）对0例；p = 0.04）。与对照组相比，治疗组使用银敷料的分娩较少，使用负压敷料的分娩较多，且诊断为孕前或孕期糖尿病的分娩较多（p < 0.05）。两组之间没有其他差异，包括腹部和阴道准备的使用、BMI > 35以及围手术期抗生素的使用。
这项单中心回顾性观察研究表明，使用CHG溶液进行腹腔内和皮下冲洗时，剖宫产术后SSI率没有差异。观察到使用CHG冲洗会使子宫内膜炎显著增加；然而，需要进一步研究以确定剖宫产中抗菌冲洗的益处或危害。
