Surgical site infection in obstetrics and gynaecology: prevention and management

Key content Surgical site infection (SSI) is an important cause of postoperative morbidity and, in severe cases, mortality. The epidemiology of SSIs varies depending on the type of surgery and the country. It is influenced by patient‐related, preoperative, intraoperative and postoperative risk factors. Prevention strategies target these risk factors and include measures taken before, during and after surgery. Learning objectives To understand how SSIs can be prevented, depending on the type of wound, especially perioperative measures including antibiotic prophylaxis, and when to institute repeat antibiotics or alter dosages. To understand the bases of and approaches to perioperative antibiotics in women with incidental infections (for example, lower genital and urinary tract) and in women with comorbidities, such as those who are immunosuppressed or with mechanical valvar heart diseases. To understand what specific measures to take to reduce the risk of SSIs in special cases in obstetrics and gynaecology, such as in morbidly obese women, those undergoing cancer surgery, or those with cardiac conditions or transplants. Ethical issues Should perioperative antibiotics be given to every woman undergoing surgery? What is the risk of antibiotic resistance as a result of administration of perioperative antibiotics?