Women undergo more cesarean sections each year in the United States than any other major surgery, with the procedure carrying a significant rate of infection at the incision site.

 Image/CDC
Image/CDC

A new study from Washington University School of Medicine in St. Louis offers strong guidance on the best way to reduce the infection risk. Rather than prepping patients with iodine-alcohol — a common antiseptic combination in C-sections — the research indicates that chlorhexidine-alcohol is significantly more effective. The researchers argue that the evidence is strong enough to change standard skin-prep practices for C-sections.

The study appears online Feb. 4 in The New England Journal of Medicine and coincides with a presentation at the Society for Maternal-Fetal Medicine’s Annual Meeting in Atlanta.

“One of the biggest complications of surgery, and of C-sections in particular, is infection,” said first author Methodius G. Tuuli, MD, assistant professor of obstetrics and gynecology. “For a new mother who needs to care for her baby — which is stressful even when all things are equal — having an infection can really impair her ability to do that. We are very interested in clarifying the best ways to prevent these infections, reducing the burden on the patients, on their infants and on the health-care system as a whole.”

An estimated 1.3 million women in the U.S. delivered their babies by C-section in 2013, with surgical-site infections complicating 5 to 12 percent of those deliveries. The average cost of treating those cesarean-related infections in the hospital is $3,500 and may be much higher for severe infections.

Read more at the Washington University School of Medicine in St. Louis