• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Does Prophylactic Negative Pressure Wound Therapy Decrease Cesarean Section Infection in Obese Women?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE: 

  • Previous studies provide conflicting data on the benefit of prophylactic negative pressure wound therapy  
  • Wihbey et al. (Obstetrics & Gynecology, 2018) sought to compare prophylactic negative pressure to standard pressure dressings in class II or III obesity undergoing cesarean section

METHODS: 

  • Randomized controlled, non-blinded, study  
  • Participants 
    • Women with BMI ≥35 undergoing cesarean section  
  • Women received either 
    • Prophylactic negative pressure therapy  
    • Standard surgical dressing 
  • Abdominal prep 
    • 2% chlorhexidine alcohol solution 
    • IV antibiotics before skin incision (ACOG guidelines) 
  • Primary outcome  
    • Superficial surgical site infection 
    • ≥1 symptom: Pain, swelling, or erythema 
  • Secondary outcomes 
    • Composite of wound complications | Wound dehiscence | Seroma | Hematoma within 30 days of surgery 
  • Low enrollment of 166 women over 24 months 
    • Interim analysis for futility was conducted and the decision was made to halt the study

RESULTS: 

  • 166 women enrolled in the study 
    • 80 prophylactic negative pressure | 81 standard dressing  
    • Mean BMI   
      • 44.9 (±8) for the prophylactic negative wound therapy group 
      • 43.4 (±7) for the standard dressing group 
  • No significant difference in composite superficial surgical site infection comparing negative pressure (31%) and standard dressing (30%)  
    • Also no difference in sub-group analysis of BMIs 40-50 or BMI >50   

CONCLUSION: 

  • Fully anticipated enrollment was not achieved, future studies are thus needed 
  • Causes for reduced enrollment 
    • Consenting required before active labor  
    • Women needed to return for wound check days 5-7 (tertiary center with a rural catchment area – practicality)  
  • There was no observed decrease in superficial surgical site infection with prophylactic negative pressure wound therapy in obese women 
  • NIH study is ongoing and therefore authors recommend against use of prophylactic negative wound therapy until those results are available

Learn More – Primary Sources: 

Prophylactic Negative Pressure Wound Therapy and Wound Complication After Cesarean Delivery in Women With Class II or III Obesity: A Randomized Controlled Trial 

image_pdfFavoriteLoadingFavorite

< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

What is the Best Practices Prevention Bundle for Post Cesarean Infection?
Can Evidence-Based Interventions Reduce C-section Complications?
Does Azithromycin Cut Infection-associated Costs Following Cesarean Section?
Does Prophylactic Negative-Pressure Decrease Cesarean Section Wound Infections?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site