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Caesarean sections are one of the most common surgical procedures performed every day in Canada. Although there has been a significant amount of research on surgical site infections (SSIs) and development of incision healing products, this information is not frequently applied to obstetrics, as they are seen as 'healthy patients'. Obstetrical patients’ risk factors are on the rise. Increases in BMI, physical conditions like diabetes and preeclampsia are changing how we look at these patients.
At the Grey Nuns Community Hospital 1,903 of the 6,010 deliveries from April 1, 2013-March 31, 2014, were by C-section. In light of new recommendations in the area of SSI prevention we decided to take a look at our current practices related to post surgical site infection prevention and dressings.
We conducted a trial using Single Use Negative Pressure dressings with nanocrystaline silver on patients considered high risk based on BMI and other risk factors.
It has lead to us develop guidelines for continued use of Single Use Negative Pressure Therapy dressing for our high risk patients, in addition to change in practice for our medium and low risk patients. We have started to see positive outcomes for patients because their surgical incisions are taken care of so they will have less time worrying about their incision and more time to bond with their new baby.
The ET nurse and OB nurse team is leading this change for our C-section patients.
References:
http://www.saferhealthcarenow.ca/EN/Interventions/SSI/Documents/SSI%20Getting%20Started%20Kit.pdf
Wilkes et al. Closed Incision Management with Negative Pressure Wound Therapy (CIM) Biomechanics. Surgical Innovation. 2012; 19(1):67-75.
Bullough,L. & Wilkinson, D.(2012) Changing wound care protocols to reduce post-operative caesarean section complications. Poster presented at Wounds. Harrogate,UK, November 2012.