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

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.

"Mirror of Patients": A Reflection on the Honor of Serving as a Male Obstetrician-gynecologist.

Physicians' work challenges them to learn and grow from their experiences with patients. Male obstetrician-gynecologists are uniquely blessed and challenged by their experiences in women's health care. The following is a reflection by one male obstetrician-gynecologist who considers the role of Saint Joseph in the holy family in contemplating his own role in providing women's health care. Summary: One hundred twenty-five men who underwent therapy trying to change sexual orientation from homosexual to heterosexual were asked about negative and positive experiences. About two-thirds recorded changes of varying extent. There was also much decrease in suicidality, depression, and substance abuse, and increases in social functioning and self-esteem. Almost all harmful effects were none to slight and comparable to therapies for other unwelcome conditions.