The Thing We Don't Know About C-Sections

Scientists have yet to prove the best way to prevent surgical site infections in women having cesarean sections.

Despite the large number of women who undergo the procedure, clinical studies have not answered the most basic of questions concerning the best antiseptic to use and how to apply it.

Six studies were identified. However, only two were reasonably large enough and even then the quality of the evidence for assessing wound infections was negligible, the authors concluded.The lack of scientific evidence when it comes to preparing a women’s skin to prevent infection following a C-section was revealed when editors from the Cochrane Pregnancy and Childbirth Group sought to review studies that compared the different antiseptics used. What they found were a number of small, poorly conducted studies that did not satisfy the standards needed for making a strong recommendation.

So even when one study found that chlorhexidine gluconate outperformed iodine alone by resulting in lower rates of bacterial growth at 18 hours post-cesarean, the evidence was deemed to be “very low quality.” And there was little or no evidence on the differences in scrubbing, swabbing, or draping the surgical site or on whether the timing and duration of preparing the site matters.