Prophylactic Negative Pressure Wound Therapy in High Risk Patients Following Cesarean Section [5I]

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Abstract

INTRODUCTION:

To date, few studies have been performed evaluating negative pressure therapy (NPT) over a closed surgical incision following Cesarean section. This study aims to determine whether placement of NPT over a closed surgical incision after Cesarean section in high risk patients will lead to a lower rate of wound complications including surgical site infection (SSI).

METHODS:

Regions Hospital initiated a policy in December 2010 wherein all patients meeting the following criteria were to have NPT placed after Cesarean section: BMI 40 or greater, or BMI 35 or greater with co-morbidities. This is a retrospective cohort study of wound complications in patients who received this intervention compared to the historical non-intervention group.

RESULTS:

In the preliminary analysis, a total of 159 patients met criteria for placement of a negative pressure dressing following Cesarean section between 12/2010 and 2/2013, with the dressing placed on 123 of these patients. This group was compared to a historical non-intervention group of 122 patients meeting the same criteria between 12/2007 and 12/2010. In patients with BMI of 40 or greater, incidence of SSI was 13.5% in the non-intervention group and 9.4% in the intervention group.

CONCLUSION:

The differences in incidence of wound complications between the groups are not statistically significant when comparing data through 2/2013, though there is a trend toward a decrease in SSI. More data are needed to determine whether this trend will become significant with a larger sample size. Data collected between 2/2013 and 12/2014 are currently being abstracted and analyzed.

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