• 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 Negative Pressure Wound Therapy Decrease Infection in Women with BMI ≥30 Post Cesarean?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE: 

  • Obesity is a risk factor of wound infection 
    • 10% of obese women will have surgical site infection post-cesarean despite use of prophylactic antibiotics  
  • Hyldig et al. (BJOG, 2018) evaluated the impact prophylactic incisional negative pressure wound therapy on surgical site infections rate in an obese population

METHODS: 

  • Unblinded, multicentered randomized controlled trial (RCT) 
  • Participants 
    • Obese women undergoing elective or emergency cesarean 
    • ≥18 years 
    • Prepregnancy BMI ≥30 kg/m2 
    • Informed consent obtained during pregnancy and patient excluded from study if delivered vaginally 
  • Standard procedures for all participants  
    • Chlorhexidine–alcohol prep 
    • Transverse lower abdominal incision 
    • Single dose of intravenous cefuroxime (1.5 or 3.0 g according to local standard procedures)
    • Choice of suture material or staples based on surgeon preference  
  • Participants were randomized to receive 
    • Incisional negative pressure wound therapy 
    • Standard dressing after caesarean section 
  • Primary outcome: Surgical site infection requiring antibiotic treatment within the first 30 days after surgery 
  • Secondary outcomes included 
    • Wound exudate | Dehiscence | Health-related quality of life 
  • Logistic regression used to adjust for the following confounders 
    • BMI (<35 and ≥35 kg/m2) | Age | Diabetes | Smoking | Blood loss | Rupture of membranes | Duration of procedure | Staples vs sutures

RESULTS: 

  • 432 women in the negative pressure group | 444 women in the standard dressing group  
  • Surgical site infection occurred significantly less often in the intervention group (P=0.007) 
    • Negative pressure: 4.6%  
    • Standard dressing: 9.2%  
    • Relative risk (RR) 0.50; 95% CI, 0.30–0.84
  • Number needed to treat: 22 
  • After adjusting for potential risk factors, the effect remained statistically significant  
  • Wound exudate was significantly less in the intervention group (P = 0.001) 
    • Negative pressure: 22.4% 
    • Standard dressing: 32.9%  
    • RR 0.69; 95% CI, 0.55–0.86
  • No differences detected for secondary outcomes, including dehiscence and quality of life between the two group

CONCLUSION: 

  • Incisional negative pressure wound therapy reduced the risk of surgical site infection in obese women receiving a cesarean section 
    • Absolute risk reduction of 4.6% 
  • There was an absolute risk reduction of 10.3% for wound exudate in the negative pressure group  

Learn More – Primary Sources: 

Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial

image_pdfFavoriteLoadingFavorite

< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Does Prophylactic Negative Pressure Wound Therapy Decrease Cesarean Section Infection in Obese Women?
Does Prophylactic Negative-Pressure Decrease Cesarean Section Wound Infections?
What is the best skin prep to prevent C-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