Antimicrobial effects of nanosilver/polyethylene glycol/chitosan in cesarean section and their impact on breastfeeding rates.

OBJECTIVE: To investigate the antibacterial effects of nanosilver (nAg)-polyethylene glycol (PEG) chitosan (CTS)-polyvinyl alcohol (PVA) dressing on post-cesarean section (CS) incisions and its impact on breastfeeding rates. METHODS: Initially, nAg-PEG-CTS-PVA, as an antibacterial dressing, was prepared using the PEG reduction method, and the morphology of nAg-PEG was observed using transmission electron microscopy. The water absorption capacity of the nAg-PEG-CTS-PVA sponge was measured, and its pore structure was observed using scanning electron microscopy. Furthermore, the in vitro release of silver particles and antibacterial effects were evaluated. Subsequently, 94 CS patients were divided into two groups: the control group (conventional antimicrobial treatment) and the nAg group (nAg antibacterial dressing), with 47 cases in each group. The outcome measures assessed included the incidence of postoperative wound infection, wound healing time, frequency of dressing changes, maternal pain intensity before and after intervention (evaluated using the visual analog scale (VAS)), LATCH breastfeeding assessment tool scores, and the exclusive breastfeeding rate within six months. RESULTS: nAg particles were uniformly dispersed in PEG, with a particle size ranging from 13 to 21 nm, predominantly spherical in shape. The CTS-PVA sponge containing nAg-PEG exhibited optimal water absorption when PVA-AH-26 accounted for 70%, displaying uniform pore distribution with higher density and pore sizes between 0.3 and 1.1 mm. The cumulative release rate reached 70% on the 8th day, and by the 28th-30th days, the cumulative release rate was 96%. The sponge demonstrated excellent bactericidal effects against Staphylococcus aureus, Gram-negative bacilli, coagulase-negative Staphylococcus, Enterococcus, and Escherichia coli. In comparison with the control group, the nAg group showed shorter wound healing time, lower wound dressing change frequency, lower visual analog scale scores, and a higher rate of exclusive breastfeeding (P < 0.05). CONCLUSION: These findings indicated that the antibacterial dressing containing nAg-PEG-CTS-PVA sponge had effective antimicrobial, analgesic, and wound healing-promoting properties, leading to a higher rate of exclusive breastfeeding after CS.