| A simple checklist for preventing major complications associated with cesarean delivery. | |
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MedLine Citation:
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PMID: 21099608 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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I propose a simple, evidence-based, eight-item checklist that, if followed, should reduce the frequency of many of the most serious complications associated with cesarean delivery: endometritis, wound infection, wound disruption, thrombophlebitis, and uterine scar dehiscence in a subsequent pregnancy. The frequency of abdominal wound infections can be reduced significantly by using electric clippers, rather than a razor, to remove the hair at the site of the surgical incision, washing the skin with a chlorhexidine solution, and administering broad-spectrum antibiotic prophylaxis before the start of surgery rather than after the neonate's umbilical cord has been clamped. Administration of broad-spectrum antibiotic prophylaxis and removal of the placenta by traction on the umbilical cord, rather than by manual extraction, will reduce the frequency of postcesarean endometritis. Closure of the uterine incision in two layers rather than one will significantly reduce the frequency of scar dehiscence in a subsequent pregnancy. Closure of the deep subcutaneous layer in patients whose subcutaneous tissue is greater than 2 cm in thickness will significantly reduce the risk of seroma, hematoma, and subsequent wound disruption. Institution of appropriate prophylaxis for deep vein thrombosis in intermediate and high-risk patients will reduce the risk of subsequent thromboembolic events. |
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Authors:
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Patrick Duff |
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Publication Detail:
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Type: Editorial |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 116 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-04 Revised Date: 2011-03-29 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1393-6 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cesarean Section*
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adverse effects,
methods Checklist* Endometritis / etiology, prevention & control Female Humans Postoperative Care Postoperative Complications / prevention & control* Pregnancy Preoperative Care Surgical Wound Dehiscence / prevention & control Surgical Wound Infection / prevention & control Thrombophlebitis / etiology, prevention & control |
| Comments/Corrections | |
Comment In:
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Obstet Gynecol. 2011 Mar;117(3):732; author reply 732
[PMID:
21343785
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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