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Summary of comments from Chris Griffin, July 1999.Author’s replyInfection following caesarean sectionmay be reduced by the use ofcord traction to remove the placenta and occlusive wound dressings.Most trials of prophylactic antibiotic therapy do not specifythe methods of placental removal and wound care, and may representa mixture of various methods. Given the clinically importantreduction of infection with antibiotic use in general, supportfor a policy of not using antibiotics would require evidence fromrandomized trials that in the context of placental removal by cordtraction and occlusive wound dressings, antibiotic therapy confersno additional benefit.ContributorsSummary of response fromFiona Smaill and Justus Hofmeyr,October1999.
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