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DOI: 10.1055/s-0039-1688822
Does a Care Bundle Reduce Racial Disparities in Postcesarean Surgical Site Infections?
Publikationsverlauf
13. Januar 2019
02. April 2019
Publikationsdatum:
14. Mai 2019 (online)
![](https://www.thieme-connect.de/media/ajp/201913/lookinside/thumbnails/10-1055-s-0039-1688822_190026-1.jpg)
Abstract
Objective To examine the effect of a care bundle on racial disparities in surgical site infections (SSIs).
Study Design This was a retrospective cohort study of women undergoing cesarean delivery at ≥23 weeks' gestation. The care bundle included routine antibiotics (both cefazolin and azithromycin), chlorhexidine skin preparation, clippers, vaginal cleansing, placental removal by cord traction, subcutaneous tissue closure, suture skin closure, dressing removal in 24 to 48 hours, and postoperative chlorhexidine soap. Our primary outcome was SSI (superficial incisional, deep incisional, and organ/space) occurring up to 6 weeks. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated, adjusting for predefined covariates.
Results Of 2,696 women, 1,947 were black (1,014 in the preimplementation period and 933 in the postimplementation period) and 749 were nonblack (370 in the preimplementation period and 379 in the postimplementation period). Regardless of race, women in the postimplementation period had lower rates of SSI compared with those in the preimplementation period (black: 2.9 vs. 5.2%, aOR: 0.53 [95% CI: 0.33–0.85]; nonblack: 1.1 vs. 3.5%, aOR: 0.28 [95% CI: 0.09–0.89]). There was no interaction by race (p for interaction = 0.94).
Conclusion The care bundle decreased SSI in both black and nonblack women but did not reduce racial disparities.
Note
This paper was presented in part as an oral presentation (#54) at the Society for Maternal-Fetal Medicine 39th Annual Pregnancy Meeting, February 11–16, 2019, Las Vegas, NV.
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