title: Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section.
abstract: BACKGROUND
  Surgical site infections (SSI) occur in 1.8%-9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS.
  
  
  METHODS
  Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression.
  
  
  RESULTS
  Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0-1.2]; p < 0.05), smoking in pregnancy (aOR = 5.34; [95% CI: 1.6-15.4]; p < 0.01), and SSD application (aOR = 2.94; [95% CI: 1.1-9.3]; p < 0.05).
  
  
  CONCLUSIONS
  The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS.
authors.affiliation: Department of Obstetrics, Gynecology, and Oncology, II Faculty of Medicine, Medical University of Warsaw , Mazovian Bródno Hospital, Warsaw, Poland .
authors.forename: Paweł Jan
authors.initials: PJ
authors.lastname: Stanirowski
authors.affiliation: Department of Obstetrics, Gynecology, and Oncology, II Faculty of Medicine, Medical University of Warsaw , Mazovian Bródno Hospital, Warsaw, Poland .
authors.forename: Magdalena
authors.initials: M
authors.lastname: Bizoń
authors.affiliation: Department of Obstetrics, Gynecology, and Oncology, II Faculty of Medicine, Medical University of Warsaw , Mazovian Bródno Hospital, Warsaw, Poland .
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Cendrowski
authors.affiliation: Department of Obstetrics, Gynecology, and Oncology, II Faculty of Medicine, Medical University of Warsaw , Mazovian Bródno Hospital, Warsaw, Poland .
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Sawicki
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000191:economics; D019072:Antibiotic Prophylaxis; D002219:Carbamates / Q000008:administration & dosage / Q000191:economics; D002585:Cesarean Section / Q000009:adverse effects* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009779:Occlusive Dressings; D011247:Pregnancy; D016037:Single-Blind Method; D013529:Surgical Wound Dehiscence / Q000191:economics / Q000209:etiology; D013530:Surgical Wound Infection / Q000191:economics / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D002219:Carbamates