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Efficacy of betaine + polyhexadine as anti-septic wound irrigating solution prior to subcutaneous layer and skin closure of cesarean section in preventing surgical site infection

Romina Grizelda O. Mallari, MD and Wilhelmina A. Mercado, MD, MHA, FPOGS
Department of Obstetrics and Gynecology, University of Santo Tomas Hospital

Background: Surgical site infection (SSI) after cesarean section occurs in 3-15% of cases. Surgical irrigation has been widely used as a measure of reducing SSI, however, there are no official guidelines for its practice.

Objective: To determine the efficacy of Betaine + Polyhexanide (Prontosan) as anti-septic wound irrigating solution prior to subcutaneous layer and skin closure of cesarean section in preventing surgical site infection.

Methodology: One hundred thirty-two women who underwent cesarean section were included from April to October 2017. The cesarean section was done according to the standard operating procedure of the hospital. All subjects were given prophylactic antibiotics prior to the cesarean section. Subjects were then randomly assigned, 66 in Prontosan and 66 in Saline as irrigating solution prior to closure of subcutaneous layer and skin. Post-operatively, subjects were monitored and evaluated for signs and symptoms of superficial surgical site infection on Day 3, 7-10 and 30.

Results: There was no demographic difference identified between the two groups (age, prepregnancy BMI, obstetric parameters and comorbidities) except that saline group had a higher proportion of emergency cesarean section (84% vs 70%). The incidence of surgical site infection 2 was similar in the two groups (15.15% vs 9.09 % on Day 3, 7.84 % vs 6.78% on Day 7-10, 3.23% vs 0 on Day 30).

Conclusion: Betaine + Polyhexanide (Prontosan) and Saline wound irrigation showed no reduction in the incidence of superficial surgical site infection in women undergoing cesarean section.

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