Abstract
Author(s): Salwa Neyazi, Khalid Akkour, Nada Alayed, Omar Alzaydan, Eman Al Shehri, Shadan Binsaeedan, Mashael Alshebly, Ahmed Sherif*, Alhassan Khedr, Sondos Al Hawamdeh, Mohammed A. Alatawi, Mohammad Atlam, Amal Kalifa, Mohammed Abdelrazeq
Background/Aim: Infections following Cesarean Sections (CS) are a notable risk. This systematic review investigates the effectiveness of changing gloves during surgery in preventing wound infections, endometritis, and febrile morbidity, focusing on whether changes occur before or after placental delivery. Methodology: Adhering to PRISMA guidelines (PROSPERO CRD420251074484), a total of eight Randomized Controlled Trials (RCTs) involving 2,168 women were sourced from databases such as MEDLINE, Scopus, and Cochrane Central, along with manual searches. The studies included were those comparing glove changes with standard care during CS. The Cochrane RoB 2.0 tool was utilized to assess bias risk. Outcomes were analyzed using a random-effects meta-analysis, with subgroup analyses based on when glove changes occurred. Heterogeneity was evaluated through I² statistics. Results: Notably, changing gloves after the delivery of the placenta resulted in a significant reduction in wound infections (RR 0.37, 95% CI 0.26–0.53, p<0.001; I²=0%). However, glove changes before placental delivery did not show a significant effect (RR 0.62, 95% CI 0.15–2.49, p=0.5). Rates of endometritis remained unchanged (RR 0.91, 95% CI 0.75–1.10, p=0.332), although febrile morbidity was reduced overall (RR 0.57, 95% CI 0.35–0.93, p=0.024). High risk of bias was observed in performance/detection due to limited blinding, and some studies had incomplete data. Conclusion: Changing gloves after placental delivery during CS is linked to fewer wound infections and febrile morbidity, endorsing its adoption as an economical preventive strategy. However, due to methodological limitations, caution is advised in interpretation, while emphasizing potential actionable insights for infection management.