Dr. Conroy is Clinical Fellow, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts.
Dr. Norwitz is Louis E. Phaneuf Professor of Obstetrics and Gynecology, Tufts University School of Medicine, and Chairman, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts. Dr. Norwitz serves on the OBG Management Board of Editors.
The authors report no financial relationships relevant to this article.
A recent systematic review of evidence-based guidelines for surgical decisions during cesarean delivery also recommended this practice based on results of 9 published studies.22 In this review, however, subcutaneous drain placement did not offer any additional benefit, regardless of tissue thickness.22
10 Avoid unproven techniques
Several commonly performed techniques have not been associated with a decreased risk of SSI after cesarean delivery
Dahlke JD, Mendez-Figueroa H, Rouse DJ, Berghella V, Baxter JK, Chauhan SP. Evidence-based surgery for cesarean delivery: an updated systematic review. Am J Obstet Gynecol. 2013;209(4):294–306.
CORONIS Trial Collaborative Group. The CORONIS Trial. International study of caesarean section surgical techniques: a randomised fractional, factorial trial. BMC Pregnancy Childbirth. 2007;7:24. doi:10.1186/1471-2393-7-24.
Familiarity with the obstetric literature will help providers determine which interventions prevent SSI and which do not. Well-designed clinical studies have demonstrated no significant difference in the rate of postcesarean infectious morbidity with the administration of high concentrations of perioperative oxygen,22 saline wound irrigation,22 placement of subcutaneous drains,22 blunt versus sharp abdominal entry,23 and exteriorization of the uterus for repair.23
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