Risk factors for wound complications in morbidly obese women undergoing primary cesarean delivery.

Autor: Thornburg LL; Department of Obstetrics & Gynecology, University of Rochester Medical Center, Rochester, NY 14642, USA. Loralei_thornburg@urmc.rochester.edu, Linder MA, Durie DE, Walker B, Pressman EK, Glantz JC
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2012 Sep; Vol. 25 (9), pp. 1544-8. Date of Electronic Publication: 2012 Feb 13.
DOI: 10.3109/14767058.2011.653422
Abstrakt: Objective: To determine factors influencing separation and infectious type wound complications (WCs) in morbidly obese women undergoing primary cesarean delivery (CD).
Methods: Retrospective cohort study evaluating infectious and separation WC in morbidly obese (body mass index [BMI] > 35 kg/m(2)) women undergoing primary CD between January 1994 and December 2008. Chi-square, Fisher's exact and Student's t tests used to assess associated factors; backward logistic regression to determine unadjusted and adjusted odds ratios.
Results: Of 623 women, low transverse skin incisions were performed in 588 (94.4%), vertical in 35 (7%). Overall WC rate was 13.5%, which varied by incision type (vertical 45.7% vs. 11.6% transverse; p < 0.01), but not BMI class. Incision type and unscheduled CD were associated with infection risk, while incision type, BMI, race and drain use were associated with wound separation.
Conclusion: In morbidly obese women both infectious and separation type WC are more common in vertical than low transverse incisions; therefore transverse should be preferred.
Databáze: MEDLINE