Implementation of vaginal preparation prior to caesarean section

BMJ Open Quality

article

Adam D Jakes¹  Annie Bell¹  Lilian Chiwera²  Jilly Lloyd¹ 

[1] Women's Services , Guy's and Saint Thomas' NHS Foundation Trust;Infection Control , Guy's and Saint Thomas' NHS Foundation Trust

关键词: cesarean delivery;    infection control;    surgical wound infection;   

DOI  :  10.1136/bmjoq-2020-000976

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Introduction Surgical site infections following caesarean section are associated with significant morbidity. Vaginal preparation is the cleansing of the vaginal epithelium with an antibacterial solution to reduce the bacterial load and therefore reduce ascending genital tract infection. It is recommended by the WHO and a Cochrane review in 2018 concluded that vaginal preparation immediately before caesarean section probably reduces the rates of postoperative endometritis.Objective To implement vaginal preparation prior to caesarean section at Guy’s and St Thomas’ Hospital NHS Foundation Trust and reduce rates of deep surgical site infections.Methods85% of eligible women, the inclusion criteria was expanded to include category I caesarean sections.Results Twelve months following implementation, vaginal preparation was still being performed in 89% of eligible women. The deep surgical site infection rate is now the lowest recorded in the last 6 years. Vaginal preparation prior to caesarean section was acceptable to pregnant women and no adverse effects were reported.Conclusions Vaginal preparation prior to caesarean section has been successfully implemented at Guy’s and St Thomas’ Hospital NHS Foundation Trust. This simple, cheap intervention, performed with readily available materials, is still being performed in a high number of caesarean sections 12 months post-implementation. It has resulted in a reduction in deep surgical site infections. Involvement of key stakeholders and the recruitment of vaginal preparation champions were key to success.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND