From the Research
Changing gloves after delivery of the infant and before handling the uterus and abdominal closure during cesarean deliveries is a crucial step in reducing the risk of surgical site infections, as evidenced by a systematic review and meta-analysis published in 2021 1. This practice is based on the understanding that bacterial contamination of surgical gloves occurs during the procedure, particularly after delivery of the infant when amniotic fluid and blood exposure is highest. By changing gloves at this critical juncture, surgeons can minimize the transfer of bacteria from the lower uterine segment and vagina to the abdominal incision and other tissues. Implementation of this practice is straightforward and requires having additional sterile gloves available in the operating room. The surgical team should change gloves after delivery of the infant and placenta, before manipulating the uterus for repair and proceeding with abdominal closure. This simple intervention has been associated with reduced rates of post-cesarean endometritis and wound infections, as supported by studies such as the one published in 2021 in the journal Scientific Reports 1. Key points to consider include:
- The importance of maintaining sterile technique throughout the procedure
- The role of glove change in preventing the transfer of bacteria from contaminated areas to clean areas
- The need for additional sterile gloves to be available in the operating room
- The potential benefits of implementing a multifaceted surgical site infection prevention bundle, as described in a study published in 2021 in the American Journal of Perinatology 2. Overall, changing gloves during cesarean delivery is a simple yet effective way to reduce the risk of surgical site infections, and its implementation should be prioritized in clinical practice, as also suggested by other studies 3, 4, 5.