Prophylactic negative pressure wound therapy on surgical site infection in obese women after cesarean section: A systematic review and meta‐analysis

Abstract

Cesarean section (CS) is the most common obstetrical surgery worldwide. Rates of cesarean section have risen as a result of numerous factors in recent years. 1,2 Obesity, defined as body mass index (BMI) ≥30, has become a common medical comorbidity of pregnancy affecting approximately one-third of reproductive-aged women in both developed and developing countries according to the World Health Organization (WHO). 3 Previous studies have reported that obese women (BMI ≥ 30) undergoing cesarean section are at increased risk of developing postoperative surgical site occurrences (SSOs), which include surgical site infection (SSI), hematoma, seroma, wound dehiscence and other wound complications. 4 The incidence of SSOs ranges from 3% to 15%. 5,6 The onset of SSOs can result in serious consequences, particularly among women with obesity. These wound complications, especially SSIs, can increase the length of hospital stay, in-hospital mortality, medical costs and delay wound healing, resulting in poor quality of life. 7 Recently, negative pressure wound therapy (NPWT) has emerged as a potential procedure for postoperative management of surgical incision primary closure. Initially introduced by Argenta and Morykwas in the mid-1990s, NPWT has developed and is currently

A systematic review with meta‐analysis on prophylactic negative pressure wound therapy versus standard dressing for obese women after caesarean section

“…Guo et al stated that the friction between polyurethane ether foams and adhesive tapes may cause impaired skin integrity, inducing blisters. (Guo et al, 2021) Notably, in our study, the results showed an insignificant difference in blistering rate between NPWT and standard dressings. Both (Guo et al, 2021)and (Gillespie et al, 2022) mentioned the high heterogeneity and low certainty of the included studies.…”

“…(Guo et al, 2021) Notably, in our study, the results showed an insignificant difference in blistering rate between NPWT and standard dressings. Both (Guo et al, 2021)and (Gillespie et al, 2022) mentioned the high heterogeneity and low certainty of the included studies. In our meta-analysis, the heterogeneity of included studies was lower than that in Guo et al's work.…”

“…Nonetheless, as our subgroup analysis uncovered, NPWT offered a statistically significant decreased SSI rate than standard dressing in the un-funded studies (Chaboyer et al, 2014;Gillespie et al, 2021;Hussamy et al, 2019;Peterson et al, 2021;Ruhstaller et al, 2017;Wihbey et al, 2018), while for those RCTs with funding from commercial company or industries (Gunatilake et al, 2017;Hyldig et al, 2018;Tuuli et al, 2020), the NPWT did not. Moreover, we noticed that the previous studies (Gillespie et al, 2022;Guo et al, 2021) reported an increased blistering rate when comparing NPWT with standard dressings. Guo et al stated that the friction between polyurethane ether foams and adhesive tapes may cause impaired skin integrity, inducing blisters.…”

“…The pre‐pregnancy obesity was increasingly prevalent in women of different ages or races (Angarita et al, 2022; Dixit & Girling, 2008; Kim et al, 2007). Obese women whose pre‐pregnancy body mass index (BMI) >30 kg/m 2 are considered to enter pregnancy with more risk (Guo et al, 2021; Vitner et al, 2019), such as the performance of caesarean delivery (Crane et al, 1997; Gregor et al, 2016; Vahratian et al, 2005). Previous research has found a link between obese women who had a caesarean section and an increased likelihood of surgical site infection (SSI) (Kawakita & Landy, 2017; Shrestha et al, 2014), which leads to the prolonged hospital stay, additional surgical procedures and increased mortality (Donowitz & Wenzel, 1980; Heslehurst et al, 2008).…”

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

“…Para realizar un procedimiento quirúrgico es necesario determinar si el paciente está en condiciones óptimas para ser interviniendo quirúrgicamente, estos indicadores se mantienen durante todo el proceso peri operatorio con el objetivo de realizar una cirugía segura y evitar complicaciones (Macías,2022), los parámetros que se evalúan son tiempo de ingreso, realización de profilaxis antimicrobianas 24 horas antes o por los menos 30 a 60 minutos antes de la incisión, para maximizar la concentración de antibióticos en los tejidos, realización del procedimiento de antisepsia del campo operatorio y control del nivel de glucemia postoperatoria en los pacientes que tengan diabetes siendo esto un factor de riesgo (Gamo et al, 2022;Guo et al,2022). ISSN en línea: 2789-3855, marzo, 2023, Volumen 4, Número 1, p. 2586.…”