{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:34:41Z","timestamp":1786653281885,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T00:00:00Z","timestamp":1513814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2018,10]]},"abstract":"Surgical site infection (SSI) following caesarean section is common, resulting in significant morbidity. Several factors are known to contribute to wound infection, including maternal, procedural and antibiotic factors. We sought to clarify these issues and sought opportunities to make improvements. A retrospective cohort study was performed assessing all women who underwent caesarean section in 2014 and 2015 at Wellington Hospital. Any women with culture\u2010positive wound samples within 30\u00a0days of surgery were identified, and clinical notes reviewed. Odds ratios (OR) were calculated for available maternal, procedural and antibiotic risk factors. Two simplified surveillance techniques were also tested for their abilities to identify significant trends. The study included 2231 women, of whom 116 (5.2%) were identified as having SSI<\/jats:styled-content>. Maternal obesity (body mass index (BMI) \u2265\u00a030) was associated with significant SSI<\/jats:styled-content> risk (OR<\/jats:styled-content> 4.1, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). The pathogen distribution was significantly different between women with BMI<\/jats:styled-content>\u00a0<\u00a030 and BMI<\/jats:styled-content>\u00a0\u2265\u00a030 (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). Increased cefazolin dose based on BMI<\/jats:styled-content> (3\u00a0g dose for BMI<\/jats:styled-content>\u00a0\u2265\u00a030) was associated with a significant reduction in SSI<\/jats:styled-content> (OR<\/jats:styled-content> 0.309, P\u00a0<\u00a0<\/jats:italic>0.001) and was administered in 74.1% of obese women receiving cefazolin. M\u0101ori women had an increased SSI<\/jats:styled-content> risk (OR<\/jats:styled-content> 2.1, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.019), as did Samoan women (OR<\/jats:styled-content> 3.0, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.002). The study reinforces other studies showing that raised BMI<\/jats:styled-content> is the single biggest risk factor for surgical site infection post\u2010caesarean section. Surveillance using simplified techniques appears to be adequate to identify trends. We believe that concentrating on appropriate antibiotic dosing and targeting special wound care measures will be pivotal interventions in improving outcomes in high\u2010risk groups.<\/jats:p>","DOI":"10.1111\/ajo.12755","type":"journal-article","created":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T13:59:53Z","timestamp":1513864793000},"page":"518-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Caesarean section wound infection surveillance: Information for action"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4572-0277","authenticated-orcid":false,"given":"Simon M.","family":"Scheck","sequence":"first","affiliation":[{"name":"Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Blackmore","sequence":"additional","affiliation":[{"name":"Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dushyant","family":"Maharaj","sequence":"additional","affiliation":[{"name":"Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand"},{"name":"School of Medicine University of Otago Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fali","family":"Langdana","sequence":"additional","affiliation":[{"name":"Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand"},{"name":"School of Medicine University of Otago Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalie E.","family":"Elder","sequence":"additional","affiliation":[{"name":"Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2012.08.014"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.116"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001064"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340701515225"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2008.06.002"},{"key":"e_1_2_6_7_1","first-page":"32","article-title":"Post\u2010caesarean section surgical site infection: rate and risk factors","volume":"124","author":"Ghuman M","year":"2011","journal-title":"N Z Med J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/501572"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016341003657884"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03452.x"},{"key":"e_1_2_6_11_1","first-page":"CD004662","article-title":"Techniques for caesarean section","volume":"1","author":"Hofmeyr GJ","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.077"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b490f1"},{"key":"e_1_2_6_14_1","first-page":"CD008726","article-title":"Different classes of antibiotics given to women routinely for preventing infection at caesarean section","volume":"11","author":"Gyte GMI","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2014.145"},{"issue":"1","key":"e_1_2_6_16_1","first-page":"72","article-title":"Changing wound care protocols","volume":"10","author":"Bullough L","year":"2015","journal-title":"Wounds UK"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2012.09.013"},{"key":"e_1_2_6_18_1","unstructured":"Screening Diagnosis and Management of Gestational Diabetes in New Zealand: A clinical practice guideline [Internet].Wellington New Zealand 2014. 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