Effect of intra-operative glove changing during cesarean section on post-operative complications: a randomized controlled trial

Arch Gynecol Obstet. 2018 Jun;297(6):1449-1454. doi: 10.1007/s00404-018-4748-y. Epub 2018 Mar 19.


Purpose: To compare the rates of wound-related complications among women undergoing a cesarean section when the surgical team used intra-operative glove changing versus usual care.

Methods: All women undergoing a cesarean section at a single, county hospital were randomized to usual care or intra-operative glove changing prior to abdominal closure. Participants were randomized at the time of decision for cesarean section; surgeons were not blinded to the randomization arm. The primary outcome was any wound-related complication, including wound hematoma, seroma, skin separation of at least 1 cm, wound infection, or other incisional abnormality requiring treatment within 8 weeks of surgery. To detect a reduction in the primary outcome from 17% in the control group to 9% in the intervention group with 80% power, a total of 554 women (277 per group) were required. Secondary outcomes included other infectious complications including endometritis and other superficial or deep soft tissue infections.

Results: From August 2015 to November 2016, 277 women were randomized to usual care and 276 women were randomized to intra-operative glove changing. The two groups were well balanced in terms of demographic data, comorbid conditions and surgical characteristics. Intra-operative glove changing led to a significant decrease in composite wound complications from 13.6% in the control group to 6.4% in the intervention group (p = 0.008).

Conclusion: Intra-operative glove changing prior to abdominal closure during cesarean section significantly reduced the incidence of post-operative wound complications.

Keywords: Cesarean section; Complications; Gloves; Infection; Obstetrics; Wound.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cesarean Section*
  • Endometritis / complications
  • Endometritis / epidemiology
  • Female
  • Gloves, Surgical*
  • Hematoma / complications
  • Hematoma / epidemiology
  • Humans
  • Incidence
  • Intraoperative Care / methods*
  • Intraoperative Period
  • Minnesota / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Period
  • Pregnancy
  • Prospective Studies
  • Seroma / complications
  • Seroma / epidemiology
  • Surgical Wound Infection / epidemiology*
  • Treatment Outcome