This study by Hinkson et al. (European Journal of Obstetrics Gynecology and Reproductive Biology, 2016) sought to determine if plastic-sheath wound retractors, which show reduced infection rates in abdominal surgery would likewise decrease rates of infection following C-section.
Randomized Controlled Trial (RCT)
Use of plastic-sheath wound retractors were compared to metal self-retaining retractors. Primary outcome, surgical site infection, was defined using CDC definitions. All patients received pre-operative antibiotics and spinal anesthetic. Operative field was cleansed suing a ethanol based solution. 98 patients underwent surgery with the Alexis, and 100 with the Collins. The use of the plastic-sheath retractor reduced infection rates 1% vs. 8% infection rate, respectively (relative risk 7.84, 95% CI 2.45-70.71; p=0.035). Secondary outcomes demonstrated easier application with the plastic-sheath as well as decreased blood loss (<500 ml, p=0.001). In the metal retractor group, there was more surgical maneuvering required (e.g. bowel repositioning, p=0.001), more scar pain (p=0.001) and higher pain medication requirements (p=0.001). There was not difference in terms of indications for C-section. The authors suggest the use of a plastic-sheath wound retractor in low-risk women undergoing their first, planned C-section significantly decreases rates of surgical site infection. (Study funded by Applied Medical Company but had no role in the study).
Please sign up or log in to your ObGFirst to access this Premium Content
Media - Internet
Computer System Requirements
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan