Cefazoline or Normal Saline Irrigation Doesn’t Reduce Surgical Site Infections After Cesarean

Cesarean surgical site infection (SSI) occurs in 3% to 17% of patients who undergo cesarean delivery. SSIs increase postcesarean maternal morbidity and health costs and cause longer hospital stays. Therefore, we designed a study to assess the effects of normal saline and cefazolin irrigation on the incidence of SSIs. In this study, 200 participants were divided into 3 groups with a 2:1:1 ratio. All pregnant women who underwent cesarean after 6 hours passed their rupture of membrane and were admitted to Shariati Hospital of Bandar Abbas were eligible for our study. Patients with immunodeficiency, coagolopathy, allergy to penicillin or cefazolin, history of immunosuppressive drug use, gestational diabetes mellitus or preeclampsia were excluded from the study. Age, gestational age, hours passed from rupture of membrane, the duration of surgery, anemia (Hb < 11), number of vaginal exams and duration of hospitalization were collected from the patients. The SPSS 13 software was used to analyze the collected data and descriptive statistics, one way ANOVA and chi-square were used. A p-value of < 0.05 was considered as significant (clinicaltrials.gov ID= NCT01566734). The mean age of the participants was 25.8 ± 5.6. The incidence of SSIs was 2.5% among all the participants. In this study, 0 patients (0%) of the cefazolin group, 1 patient (2%) of the normal saline group and 4 (4%) of the control group developed SSIs. No significant relation was seen between age, the number of vaginal exams, mean gestational age, duration of surgery, anemia and the type of irrigation. The results of this study show that normal saline or cefazolin irrigation does not decrease the incidence of SSIs. However, these solutions might have a different impact on high-risk patients.