Prevena™, negative pressure wound therapy applied to closed Pfannenstiel incisions at time of caesarean section in patients deemed at high risk for wound infection.
The aim of our retrospective study is to report on our experience using the Prevena™ wound system in obese patients undergoing caesarean section delivery. A total of 26 cases were identified from July 2012 to October 2013. The median BMI of these women was 45.3 kg/m(2). Elective caesarean sections were performed in 20 women (77%). There were four cases (15%) of superficial dehiscence. Factors associated with wound breakdown were wound infection (p = 0.03), increasing BMI (p < 0.001) and emergency LSCS (p = 0.04). In a logistic regression model the presence of infection was the only factor which remained associated with wound breakdown. Wound disruption is a major cause of morbidity following caesarean section in morbidly obese patients. The wound complication rate in our experience was low with the Prevena™ dressing with no cases of sheath dehiscence, and no patient required a second operation. The presence of infection is the most important factor in wound breakdown and should be the focus for management protocols.
Department of Obstetrics and Gynaecology, Coombe Women and Infant University Hospital , Dublin , Ireland.
B
B
Anglim
H
H
O'Connor
S
S
Daly
D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation*; D009767:Obesity, Morbid / Q000150:complications; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*
High-risk pregnancy; Prevena™ negative pressure wound therapy; obesity in pregnancy; wound infection