Subcutaneous Antibiotic Irrigation to Prevent Wound Infection in Obese Patients Undergoing Cesarean Section

Abstract

urgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients (Leaper, 2010). SSIs result in prolonged hospitalization and increase the probability of intensive care unit admission and readmission to the hospital with increased mortality (Engemann et al., 2003). As a result, SSIs represent a substantial financial burden for both the patient and the health service (Urban, 2006). The SSIs-related actual cost may be even higher than estimated due to underreporting and the financial cost to society from disability payments, loss of tax revenue, and lost productivity (Chang et al., 2013). Obesity is an independent risk factor for post-operative surgical site infection. The risk of post-cesarean surgical site infection has been shown to double for every 5 unit increase in body mass index (BMI) above 30 kg/m , occurring in about 10% of obese women undergoing caesarean section despite prophylactic strategies e.g. antibiotics (Hyldig et al., 2019). Antibiotic prophylaxis has been a cornerstone in SSI prevention, and there is growing interest in the local delivery of antibiotics. Local delivery can potentially lead to a higher concentration of antibiotics within the target site while minimizing the risk of systemic toxicity (Chang et al., 2013).