Negative pressure therapy for CD incision: no complication benefit with high BMI

  • Hussamy DJ & al.
  • Obstet Gynecol
  • 10 Sep 2019

  • International Clinical Digest
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Takeaway

  • Prophylactic closed-incision negative pressure therapy in obese women undergoing cesarean delivery (CD) does not reduce the risk for wound complications.

Why this matters

  • 40% of US women have obesity.
  • Wound complications in women with obesity undergoing CD add to annual medical expenditures.

Key results

  • The overall wound morbidity was 18%.
  • There was no difference in wound morbidity between groups (P=.54).

Study design

  • Pragmatic, open-label randomized controlled trial at 1 institution between 2015 and 2016.
  • Gravid women with obesity were invited to participate.
  • BMI was measured within 2 weeks prior to delivery.
  • Women undergoing CD with BMI ≥40 kg/m2 were randomly allocated to receive a standard dressing (n=219) vs closed-incision negative pressure therapy (n=222).
  • Primary outcome was wound complication (wound disruption, wound infection, or cellulitis).
  • Funding: None; study materials provided by Kinetic Concepts Incorporated.

Limitations

  • Results may not be generalizable; most patients were Hispanic and from a public hospital setting.