Limited Efficacy and Adverse Effect of Sodium Hyaluronic
Acid-Carboxymethylcellulose and Oxidized Regenerated Cellulose at
Primary Cesarean Delivery
Abstract
Introduction: Adhesion is associated to delayed delivery of the neonate
and higher incidence of intraoperative and postoperative complications.
Currently, there is no definite consensus regarding the use of adhesion
barriers at cesarean section. Objective: To analyze the postoperative
outcomes among two adhesion barrier groups and control group at the
primary and the secondary cesarean section. Methods: This retrospective
study includes 199 Asian women undergoing primary and secondary cesarean
section between January1, 2011, and September 31, 2019. We used
regression to analyze risk factors of postcesarean fever at primary
cesarean section. Further we used interaction analysis to examine the
effect of surgical site infection risk factors and use of adhesion
barrier on postcesarean fever rates at the primary cesarean section.
Results: We found that use of adhesion barrier at the primary cesarean
section is associated with a significantly higher incidence of
postcesarean fever (p=0.045). The risk factor for postcesarean fever is
the use of anti-adhesion filmduring emergency cesarean section
(p=0.041). In the subgroup of labor before operation and emergency
cesarean section, adhesion barrier user had significant higher risk of
postcesarean fever than nonuser (p<0.05). Conclusion: The
patients used of anti-adhesion films during emergency cases and when a
woman has labor before operation is associated with a significantly
higher risk of postcesarean fever which potentially means increased risk
of surgical site infection.