Negative pressure wound therapy prevents SSI in fat women undergoing C section: BMJ

Australia: Prophylactic closed incision negative pressure wound therapy (NPWT) may be effective in preventing surgical site infection (SSI) in obese women undergoing cesarean section, finds a recent study in BMJ. However, NPWT use was associated with a small but significant skin blistering risk. 

Postoperative wound complications including dehiscence, SSI, formation of seroma, and hematoma are common complications of surgical procedure, especially in women with diabetes, obesity, or both undergoing C-section. SSI is a global concern contributing to re-intervention and treatment, delayed wound healing, increased length of hospital stay, and in some cases death. Maternal obesity increases the woman's risk of developing SSI and other wound complications threefold, which delays recovery, increases discomfort, and reduces the quality of life.

Brigid M Gillespie, Griffith University, Gold Coast, Qld, Australia, and colleagues aimed to determine the effectiveness of closed incision negative pressure wound therapy (NPWT) compared with standard dressings in preventing surgical site infection in obese women undergoing caesarean section.

For this purpose, they conducted a multicentre, pragmatic, randomised, controlled, parallel group, superiority trial across four Australian tertiary hospitals between October 2015 and November 2019. It included 2035 women having a pre-pregnancy body mass index of 30 or greater and gave birth by elective or semi-urgent caesarean section. They were randomized before the caesarean procedure to closed incision NPWT (n=1017) or standard dressing (n=1018). Allocation was concealed until skin closure.