Incisional negative pressure therapy to prevent wound complications following cesarean section in morbidly obese women: a pilot study.
OBJECTIVE
We sought to evaluate the efficacy of incisional negative pressure therapy in decreasing postoperative wound complications when placed prophylactically over clean, closed incisions following cesarean section in obese patients.


METHODS
This was a retrospective cohort study comparing rates of wound complications following cesarean sections in morbidly obese women prior to and following the institution of standard use of prophylactic incisional negative pressure therapy. All women with a body mass index greater than 45 kg/m(2) undergoing cesarean section in a 2-year period in a single institution were included. The exposure was incisional negative pressure therapy, which began in September 2009, versus standard wound dressing used in the previous year. The main outcome was wound complication identified by ICD-9 codes. Demographic and wound outcomes were compared with χ(2) and t tests. Stata version 11.0 was used for all analysis.


RESULTS
A total of 63 women met the inclusion criteria, 21 of whom received negative pressure wound therapy. The historical comparison and exposure groups were similar in all characteristics studied with the exceptions of length of surgery (64 vs 76 minutes, P = .03), length of labor (78 vs 261 minutes, P = .02), scheduled versus nonscheduled (77% vs 52%, P = .04), and mean age (29.5 vs 26.1 years, P = .04), respectively. There were 5 wound complications in the control group (10.4%) and none (0%) in the study group (P = .15).


CONCLUSIONS
This pilot study suggests a decrease in wound complications in morbidly obese women receiving incisional negative pressure therapy following cesarean section.
University of Maryland, Baltimore, MD, USA kmark@fpi.umaryland.edu.
Katrina S
KS
Mark
University of Maryland, Baltimore, MD, USA.
Lindsay
L
Alger
University of Maryland, Baltimore, MD, USA.
Mishka
M
Terplan
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
cesarean section; negative pressure therapy; obesity; wound complication