Topical Application of Antibiotic Prophylaxis in The Prevention of Surgical Site Infection after Elective Lower Segment Cesarean Section: A Randomized Controlled Study

Background: Surgical site infections (SSIs) are a significant concern in surgical procedures, including elective lower segment cesarean sections (LSCS). The use of prophylactic antibiotics is a common practice aimed at reducing the incidence of SSIs. Objective: This study aimed to establish benefit from the use of topical antibiotics prophylaxis after skin closure to decrease rate of surgical site infection in women undergoing elective lower segment Caesarean section (LSCS) in comparison with ordinary dressing with povidone-iodine.
Subjects and methods: A randomized controlled trial was conducted on 122 subjects divided into 2 equal groups; group A (study) included patients who had topical fucidic acid immediately after subcuticular stitches followed by dry dressing and group B (control) included patients who had simple dressing with povidone-iodine. Postoperatively, maternal temperature was measured on 2 separate occasions 6 hours apart with exclusion of the first 12 hours following surgery. The wound was inspected 48 hours, 7 days and 30 days after Caesarean section for signs of superficial or deep incisional surgical site infection. Observation for endometritis and detection of urinary tract infection were also performed.
Results: Surgical site infection was significantly less frequent among study group than among control group 1 (1.6%) vs. 8 (13.1%). No significant differences were noted between study groups regarding age, body mass index (BMI), gestational age (GA), parity, previous Caesarean section (CS), rupture of membrane (ROM) and duration of CS.
Conclusion: The use of fucidin cream followed by dry dressing after closure of skin in elective Caesarean section do decrease the rate of SSIs.