Conclusion
The finding that obesity is a significant risk factor in the development
of an SSI following CS highlights the importance of appropriate wound
management in this patient group. Frequent wound cleaning and the use of
appropriate dressings, along with regular dressing changes is an
important aspect of wound care for health care professionals and
patients and demonstrates the importance of education in skin integrity.
The prevention of wound ischemia could also help to reduce the risk of
SSI as fat necrosis can lead to the development of an infection.51 Surgical wound irrigation could also help to lower
the risk of an SSI developing following an emergency CS, with surgeons
using antibacterial solutions to flush out the wound site in order to
remove any contaminants. 52 Targeted weight management
interventions for individuals with a higher BMI could also limit the
risks associated with an increased BMI. Improved guidelines and
strategies for at-risk patients would also enable clinicians to manage
emergency CS patients better and reduce the risk of SSI development.
Whilst some research has focused on investigating risk factors of
developing and SSI in CS, there has been less of a focus on the
difference between the risks associated with emergency and elective CS
procedures and there has been a distinct lack of evidence pertaining the
risk factors for emergency CS in particular.
This study identified BMI (kg/m2) as a significant
risk factor associated with the development of an SSI in emergency CS’s.
Possible reasons for BMI’s (kg/m2) significance could
be the negative effect of excessive adipose tissue on the body’s immune
system as well as the reduced effectiveness of antibiotics in
individuals with an obese BMI (kg/m2). Other potential
risk factors such as diabetes status, patient age and pre-op vaginal
swab did not reach statistical significance in this study. Future
research on larger samples should be conducted to validate these
findings to substantially improve the knowledge and evidence base on the
treatment and management of SSI and associated risk factors following
emergency CS.