| Autor: |
Brigid M. Gillespie, PhD, David Ellwood, MD, DPhil (Oxon), FRANZCOG (MFM), DDU, Lukman Thalib, PhD, Sailesh Kumar, MD, DPhil (Oxon), Kassam Mahomed, MD, FRANZCOG, Evelyn Kang, PhD, Wendy Chaboyer, PhD |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
AJOG Global Reports, Vol 2, Iss 3, Pp 100069- (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2666-5778 |
| DOI: |
10.1016/j.xagr.2022.100069 |
| Popis: |
BACKGROUND: Surgical wound complications are common and occur in between 3% and 12% of obese women after cesarean delivery. An understanding of the risk factors for wound complications may inform potential areas for clinical care improvement. OBJECTIVE: This study aimed to identify the incidence and predictors of surgical wound complications in obese women after cesarean delivery. STUDY DESIGN: This was a secondary analysis of the ADding negative pRESSure to improve healING, or DRESSING, randomized controlled trial conducted at 4 maternity hospitals in Australia. A total of 2035 women with a prepregnancy body mass index ≥30 kg/m2 undergoing cesarean delivery were included. Data were collected between October 2015 and December 2019 using self-reporting of signs and symptoms, the research nurses’ direct observation of the surgical site, and medical records. Independent blinded outcome assessors ascertained wound outcomes on the basis of self-reported data and medical records. Multivariable logistic regression models were used to identify independent risk factors for wound complications and surgical wound dehiscence. The 30-day cumulative incidence of wound complications and surgical wound dehiscence was calculated. RESULTS: Of the 2035 women, 317 (15.6%) developed a wound complication, whereas 211 (10.4%) developed surgical wound dehiscence. The predictors of a wound complication included 1 previous cesarean delivery (odds ratio, 1.41; 95% confidence interval, 1.05–1.90; P=.02) and ruptured membranes >12 hours (odds ratio, 1.69; 95% confidence interval, 1.08–2.66; P=.02). The odds of developing any wound complication decreased by 45% with vaginal cleansing (odds ratio, 0.55; 95% confidence interval, 0.42–0.72; P12 hours (odds ratio, 1.85; 95% confidence interval, 1.10–3.12; P=.02). The odds of developing surgical wound dehiscence decreased by 50% for vaginal cleansing (odds ratio, 0.50; 95% confidence interval, 0.36–0.69; P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
