Management of wound complications from cesarean delivery.
Multiple factors account for the increasing number of cesarean delivery wound complications in the United States; among them are an increase in cesarean delivery and an increase in the number of overweight and obese patients. This article reviews the pathophysiology of acute wound healing. Risk factors for cesarean delivery wound complications are identified and described. Clinical practices that can reduce the risk of developing wound complications, including Centers for Disease Control and Prevention guidelines, are considered. Treatment guidelines to accelerate wound healing such as secondary closure and negative pressure wound therapy in disrupted wounds are proposed. Older guidelines for management of wounds using secondary intention are critiqued. Historical methods of wound care such as the practice of using certain cleansers and the practice of wet to dry dressings are outdated. Modern wound healing products are described.


BACKGROUND
Obstetricians & Gynecologists, Family Physicians


OBJECTIVE
After completion of this article, the reader should be able to describe the effects of obesity on cesarean delivery wound healing, to improve methods of wound healing in the obese patient, and to explain why wet to dry dressing changes are not effective wound management.
Sarsam
Sue Ellen
SE
Phoenix Perinatal Associates, an Affiliate of Obstetrix Medical Group of Phoenix, PC, Phoenix, Arizona 85006, USA.
Elliott
John P
JP
Lam
Garrett K
GK
D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013530:Surgical Wound Infection / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology*