Negative pressure wound therapy Vs standard dressings in obe
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Prophylactic closed incision negative pressure wound therapy (NPWT) may be effective in preventing surgical site infection (SSI) in obese women undergoing cesarean section, finds a study in BMJ. However, NPWT use was associated with a small but significant skin blistering risk.

The sim was to determine the effectiveness of closed incision negative pressure wound therapy (NPWT) compared with standard dressings in preventing surgical site infection (SSI) in obese women undergoing cesarean section.

This multicentre, pragmatic, randomised, controlled, parallel-group, superiority trial, included eligible women who had a pre-pregnancy body mass index of 30 or greater and gave birth by elective or semi-urgent cesarean section. 2035 consenting women were randomized before the cesarean procedure to closed incision NPWT (n=1017) or standard dressing (n=1018).

-- In the primary intention to treat analysis, SSI occurred in 75 women treated with closed incision NPWT and in 99 women with a standard dressing.

-- Post hoc sensitivity analyses to explore the effect of missing data found the same direction of effect, with statistical significance.

--Blistering occurred in 40/996 women who received closed incision NPWT and in 23/983 who received the standard dressing.

Conclusively, prophylactic closed incision NPWT for obese women after cesarean section resulted in a 24% reduction in the risk of SSI compared with standard dressings.

BMJ
Source: https://doi.org/10.1136/bmj.n893
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