Katrina S Mark1, Lindsay Alger2, Mishka Terplan2. 1. University of Maryland, Baltimore, MD, USA kmark@fpi.umaryland.edu. 2. University of Maryland, Baltimore, MD, USA.
Abstract
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. STUDY DESIGN: 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.
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 obesepatients. STUDY DESIGN: This was a retrospective cohort study comparing rates of wound complications following cesarean sections in morbidly obesewomen 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 obesewomen receiving incisional negative pressure therapy following cesarean section.
Authors: Perry Shen; Aaron U Blackham; Stacey Lewis; Clancy J Clark; Russell Howerton; Harveshp D Mogal; Rebecca M Dodson; Gregory B Russell; Edward A Levine Journal: J Am Coll Surg Date: 2017-01-11 Impact factor: 6.113
Authors: Lulu Yu; Ryan J Kronen; Laura E Simon; Carolyn R T Stoll; Graham A Colditz; Methodius G Tuuli Journal: Am J Obstet Gynecol Date: 2017-09-23 Impact factor: 8.661
Authors: Michael Engelhardt; Norah A Rashad; Christian Willy; Christian Müller; Christian Bauer; Sebastian Debus; Tino Beck Journal: Int Wound J Date: 2018-03-12 Impact factor: 3.315
Authors: Paweł Jan Stanirowski; Anna Wnuk; Krzysztof Cendrowski; Włodzimierz Sawicki Journal: Arch Gynecol Obstet Date: 2015-04-12 Impact factor: 2.344
Authors: Christopher N J Young; Ka Ying Bonnie Ng; Vanessa Webb; Sarah Vidow; Rajeswari Parasuraman; Sameer Umranikar Journal: Medicine (Baltimore) Date: 2016-12 Impact factor: 1.889
Authors: Fleur E E De Vries; Elon D Wallert; Joseph S Solomkin; Benedetta Allegranzi; Matthias Egger; E Patchen Dellinger; Marja A Boermeester Journal: Medicine (Baltimore) Date: 2016-09 Impact factor: 1.889