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.