Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial

Autor: Camilla Bille, Ole Mogensen, Lene Nyhøj Heidemann, Jens Ahm Sørensen, Jan Stener Joergensen, Ronald F. Lamont, Christina Anne Vinter, Marie Kruse, Mette Holm Ibsen, C. Rorbye, Mette Tanvig, Nana Hyldig, Per Ovesen, Chunsen Wu, J.B. Laursen
Rok vydání: 2018
Předmět:
Adult
incisional negative pressure wound therapy
obesity
medicine.medical_specialty
Denmark
medicine.medical_treatment
Population
Article
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Pregnancy
Risk Factors
law
Negative-pressure wound therapy
MANAGEMENT
medicine
Humans
Surgical Wound Infection
Caesarean section
Obesity
education
Wound Healing
education.field_of_study
030219 obstetrics & reproductive medicine
Cesarean Section
business.industry
General Obstetrics
Obstetrics and Gynecology
Standard of Care
surgical site infection
medicine.disease
Bandages
CDC DEFINITIONS
Surgery
Pregnancy Complications
EQ-5D-3L
Clinical trial
Treatment Outcome
Relative risk
Number needed to treat
Female
business
Surgical site infection
Negative-Pressure Wound Therapy
Zdroj: Hyldig, N, Vinter, C A, Kruse, M, Mogensen, O, Bille, C, Sorensen, J A, Lamont, R F, Wu, C, Heidemann, L N, Ibsen, M H, Laursen, J B, Ovesen, P G, Rorbye, C, Tanvig, M & Joergensen, J S 2019, ' Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women : a pragmatic randomised clinical trial ', B J O G, vol. 126, no. 5, pp. 628-635 . https://doi.org/10.1111/1471-0528.15413
Hyldig, N, Vinter, C A, Kruse, M, Mogensen, O, Bille, C, Sorensen, J A, Lamont, R F, Wu, C, Heidemann, L N, Ibsen, M H, Laursen, J B, Ovesen, P G, Rorbye, C, Tanvig, M & Joergensen, J S 2019, ' Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women : a pragmatic randomised clinical trial ', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 126, no. 5, pp. 628-635 . https://doi.org/10.1111/1471-0528.15413
Bjog
ISSN: 1470-0328
Popis: Objective To evaluate the reduction of surgical site infections by prophylactic incisional negative pressure wound therapy compared with standard postoperative dressings in obese women giving birth by caesarean section. Design Multicentre randomised controlled trial. Setting Five hospitals in Denmark. Population Obese women (prepregnancy body mass index (BMI) ≥30 kg/m2) undergoing elective or emergency caesarean section. Method The participants were randomly assigned to incisional negative pressure wound therapy or a standard dressing after caesarean section and analysed by intention‐to‐treat. Blinding was not possible due to the nature of the intervention. Main outcome measures The primary outcome was surgical site infection requiring antibiotic treatment within the first 30 days after surgery. Secondary outcomes included wound exudate, dehiscence and health‐related quality of life. Results Incisional negative pressure wound therapy was applied to 432 women and 444 women had a standard dressing. Demographics were similar between groups. Surgical site infection occurred in 20 (4.6%) women treated with incisional negative pressure wound therapy and in 41 (9.2%) women treated with a standard dressing (relative risk 0.50, 95% CI 0.30–0.84; number needed to treat 22; P = 0.007). The effect remained statistically significant when adjusted for BMI and other potential risk factors. Incisional negative pressure wound therapy significantly reduced wound exudate whereas no difference was found for dehiscence and quality of life between the two groups. Conclusion Prophylactic use of incisional negative pressure wound therapy reduced the risk of surgical site infection in obese women giving birth by caesarean section. Tweetable abstract RCT: prophylactic incisional NPWT versus standard dressings postcaesarean in 876 women significantly reduces the risk of SSI.
Tweetable abstract RCT: prophylactic incisional NPWT versus standard dressings postcaesarean in 876 women significantly reduces the risk of SSI.
Databáze: OpenAIRE
Externí odkaz: