BACKGROUND AND PURPOSE: 

• Previous small randomized trials were inconclusive as to whether changing gloves during cesarean section prevents post-operative wound infections  
• Scrafford et al. (Archives of Obstetrics and Gynecology, 2018) assessed the impact of intra-operative glove changing on rates of wound-related complications among women undergoing a cesarean section  

METHODS: 

• Prospective randomized controlled trial 
• Participants: Women undergoing cesarean section for any indication 
• All patients received appropriate pre-operative measures to prevent infection  
• Vaginal preparation and cesarean delivery techniques were at the discretion of the attending surgeon 
• Participants were randomized into the following groups  
  • Intra-operative glove change where all members of the surgical team (including assistants and scrub technicians) replaced their outer gloves just prior to abdominal closure 
  • Usual care 
• Abdominal closure was defined as prior to peritoneal closure and not prior to placental delivery due to risk for increased blood loss  
• Primary outcome: Any wound-related complication including 
  • Wound hematoma 
  • Seroma  
  • Skin separation of at least 1 cm  
  • Wound infection 
  • Incisional abnormality requiring treatment within 8 weeks of surgery 
• Secondary outcomes included  
  • Other infections complications including endometritis and superficial or deep soft tissue infections 

 RESULTS: 

• 277 women were included in the usual care group and 276 in the glove changing group 
• Composite wound complications were significantly lower in the intra-operative glove changing group (6.4%) compared to the non-intervention group (13.6%); p=0.008 
• Adjusted for vaginal preparation had little impact on the result  
  • Adjusted odds ratio 0.43 (95% CI 0.23, 0.81), p = 0.009  

CONCLUSION: 

• Intra-operative glove changing prior to abdominal closure during cesarean section reduces the incidence of post-operative wound complication 

Learn More – Primary Sources: 

Effect of intra-operative glove changing during cesarean section on post-operative complications: a randomized controlled trial.

Related ObG Topics:

Can Evidence-Based Interventions Reduce C-section Complications?

What is the Best Practices Prevention Bundle for Post Cesarean Infection?

Does Vaginal Cleansing Prevent Endometritis Following Cesarean Section?