Prophylactic Negative Pressure Wound Therapy for Obese Women After Cesarean Delivery
| Autor: | Marcela C. Smid, Sarah K. Dotters-Katz, Abbey J Hardy-Fairbanks, Sarah Towner Wright, Margaret S. Villers, David M. Stamilio, Matthew R. Grace |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Surgical Wound Body Mass Index 03 medical and health sciences Postoperative Complications 0302 clinical medicine Pregnancy Negative-pressure wound therapy Humans Medicine Obesity 030212 general & internal medicine Cesarean delivery 030219 obstetrics & reproductive medicine Cesarean Section business.industry Obstetrics and Gynecology Prophylactic Surgical Procedures Surgery Pregnancy Complications Treatment Outcome Meta-analysis Female Wound complication Electronic database business Body mass index Negative-Pressure Wound Therapy |
| Zdroj: | Obstetrics & Gynecology. 130:969-978 |
| ISSN: | 0029-7844 |
| Popis: | To summarize available studies on wound complication outcomes after prophylactic negative pressure wound therapy for obese women (body mass index 30 or greater).We conducted a systematic review and meta-analysis using electronic database search (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Google scholar, and Web of Science), Cochrane, and trial registries including ClinicalTrials.gov.We conducted an electronic search of research articles from 1966 to January 2017 for randomized controlled trials (RCTs), prospective cohort, and retrospective cohort studies of negative pressure wound therapy compared with standard dressing after cesarean delivery among obese women. Our primary outcome was defined as a composite of wound complication, including wound or surgical site infection, cellulitis, seroma, hematoma, wound disruption, or dehiscence. For cohort studies and RCTs, we performed a descriptive systematic review. For available RCTs, we performed a meta-analysis and pooled risk ratios using a random-effects model. We assessed for heterogeneity using χ test for heterogeneity and I test. We assessed for publication bias using a funnel plot.Of 10 studies meeting eligibility criteria, five were RCTs and five were cohort studies. Results of cohort studies were varied; however, all had a high potential for selection bias. In the meta-analysis, there was no difference in primary composite outcome among those women with negative pressure wound therapy (16.8%) compared with those who had standard dressing (17.8%) (risk ratio 0.97, 95% CI 0.63-1.49). There was no statistically significant heterogeneity (χ test 4.80, P=.31, I=17%).Currently available evidence does not support negative pressure wound therapy use among obese women for cesarean wound complication prevention.PROSPERO: International prospective register of systematic reviews, 42016033948. |
| Databáze: | OpenAIRE |
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