Postcesarean surgical site infections (SSIs) contribute substantially to morbidity and healthcare costs, yet understanding of their management remains limited.

Retrospective cohort study of patients delivering via cesarean at a single healthcare system from June 2013 to July 2022 with SSIs within 30 days of delivery. Rates and risk factors for surgical intervention were examined as the primary outcome. Secondary analysis evaluated outcomes in those who required surgical versus conservative management.

Of 533 patients, 69 (12.9%) required surgical management; this population was less likely to have private insurance and more likely to have diabetes than patients managed conservatively. Factors independently associated with surgical intervention included body mass index (BMI) 40 to 49.9, BMI ≥ 50, hypertensive disorders of pregnancy, blood transfusion, general anesthesia, and penicillin allergy. Among 297 patients evaluated, patients requiring surgical intervention(n = 69, 23.2%) experienced higher rates of morbidity, including sepsis, acute kidney injury, and fascial dehiscence. Patients requiring surgical intervention had higher rates of inpatient admission, intensive care unit admission, and longer readmissions.

Patients with higher BMI, hypertensive disorders of pregnancy, general anesthesia, blood transfusion, and penicillin allergies may warrant closer monitoring for wound infection. Furthermore, patients requiring surgical intervention for postpartum wound infections had higher morbidity and longer, more complex hospitalizations.

Data are available upon reasonable request.

J.W.: conceptualization, data curation, investigation, and writing—original draft. E.E.H.P.: investigation and writing—review and editing. Y.Z., A.C., M.G., C.M., S.B.A., C.R.G., and J.O.: investigation and writing—original draft. R.W.: conceptualization, investigation, and writing—review and editing. S.K.D.-K.: conceptualization, data curation, formal analysis, investigation, methodology, supervision, and writing—review and editing.

Received: 17 November 2025

Accepted: 14 January 2026

Accepted Manuscript online:
31 January 2026

Article published online:
09 February 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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