Comprehensive Measures for Preventing Obstetric Surgical Site Infections: An Evidence-Based Narrative Review

Abstract

Background: Surgical site infections remain a significant cause of postpartum morbidity, especially following cesarean section—the most frequently performed obstetric surgery worldwide. Despite advances in perioperative care, the incidence of obstetric surgical site infection remains high in many settings, particularly in low- and middle-income countries. Objective: To synthesize current evidence on comprehensive strategies for preventing obstetric, surgical site infection focusing on pre-operative, intra-operative, post-operative, and institutional measures. Methods: A narrative review of literature published between 2010 and 2025 was conducted through PubMed, Cochrane Library, Embase, and Google Scholar. Keywords included “obstetric,” “cesarean,” “surgical site infection,” and “prevention.” Guidelines, randomized controlled trials, cohort studies, and reviews related to surgical site infection prevention in obstetrics were included. Findings: Evidence demonstrates that a multifaceted approach—incorporating optimized timing of antibiotic prophylaxis, proper skin preparation, adherence to aseptic protocols, surgical technique refinement, postoperative wound care, and robust institutional surveillance—significantly reduces surgical site infection incidence. Timely antibiotic prophylaxis (within 30–60 minutes before incision) and the use of alcohol-based chlorhexidine skin antisepsis have the strongest evidence base. Conclusion: Preventing obstetric of surgical site infection requires coordinated interventions across the entire perioperative timeline. Implementing standardized protocols, strengthening infection-control systems, and promoting continuous training can substantially reduce postoperative morbidity and improve maternal outcomes.