ASSIST
Research type
Research Study
Full title
A prospective study evaluating the use bacterial auto-fluorescence imaging and three-dimensional imaging in women with surgical site infection following caesarean section
IRAS ID
284835
Contact name
Abdul H. Sultan
Contact email
Sponsor organisation
Croydon Health Services
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Approximately in the United Kingdom, 29% of women undergo caesarean section. Surgical site infection(SSI) is one of the most common complication following caesarean section. Wounds can be contaminated from the surrounding skin bacteria, environment or external sources such as the gastrointestinal or genitourinary tract. Minimising bacterial burden by antibiotic prophylaxis and skin anti-sepsis prior to skin incision at caesarean section is fundamental in the prevention of SSI as it decreases bacterial load at the future surgical site. However, following skin cleansing with anti-septics, bacteria can be displaced from the surgeons glove following delivery of the baby and intra-abdominally; particularly from the womb, to the skin surface of the patient.
On clinical review of SSI, wound swabs can be taken however the results of these can take 2-5 days, which can delay management. Special hand-held cameras have been created and are currently used in wounds such as leg ulcers and burns. Firstly, they can diagnose wound infection by stimulating bacteria to produce fluorescence light, and have been shown to correctly diagnose wound infection due to 28 of the 32 common causative bacteria. They can also accurately measure wound size, area and depth. There are predictors of the final wound healing outcome. But traditional methods of measuring wounds including the ruler method has been shown to be inaccurate and overestimate wound size by up to 41% as it does not take into account wound irregularities. No study has used these imaging techniques in caesarean section wounds.
We firstly plan to characterise wound bacterial load patterns following intra-operative cleaning of the skin with anti-septics. In addition we plan to describe the appearance of caesarean section wound infections using special hand held cameras which can diagnose wound infection and accurately measure wounds that have broken down, at the bedside.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
20/LO/1049
Date of REC Opinion
11 Jan 2021
REC opinion
Further Information Favourable Opinion