title: Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol.
abstract: Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3-15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence. We propose to conduct the first systematic review and meta-analysis to determine the pooled estimate for the overall incidence of SSI following CS.
  
  
  
  We will perform a comprehensive search to identify all potentially relevant published studies on the incidence of SSI following CS reported from 1992 in the English language. Electronic databases including PubMed, CINAHL, EMBASE and Scopus will be searched using a detailed search strategy. Following study selection, full-text paper retrieval, data extraction and synthesis, we will appraise study quality and risk of bias and assess heterogeneity. Incidence data will be combined where feasible in a meta-analysis using Stata software and fixed-effects or random-effects models as appropriate. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  
  
  
  Ethical approval is not required as this review will use published data. The review will evaluate the overall incidence of SSI following CS and will provide the first quantitative estimate of the magnitude of SSI. It will serve as a benchmark for future studies, identify research gaps and remaining challenges, and emphasise the need for appropriate prevention and control measures for SSI post-CS. A manuscript reporting the results of the systematic review and meta-analysis will be submitted to a peer-reviewed journal and presented at scientific conferences.
  
  
  
  CRD42015024426.
authors.affiliation: Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland.
authors.forename: Khalid B M
authors.identifier: 0000-0002-2676-520X
authors.initials: KB
authors.lastname: Saeed
authors.affiliation: Cork University Maternity Hospital, Cork, Ireland.|Departments of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Greene
authors.affiliation: Departments of Obstetrics and Gynaecology, National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Corcoran
authors.affiliation: INFANT: Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, Cork, Ireland.
authors.forename: Sinéad M
authors.initials: SM
authors.lastname: O'Neill
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D011159:Population Surveillance; D011247:Pregnancy; D036301:Qualitative Research; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
keywords: Caesarean Section; Incidence; Pregnancy; Surgical Site Infection; meta-analysis, Systematic review; EPIDEMIOLOGY; OBSTETRICS