Prophylactic NPWT on Wound Complications After Cesarean Delivery

In this study, the authors (Ana M Angarita, Jenani Jayakumaran, Daniele Di Mascio, Vincenzo Berghella) aimed to assess whether negative pressure wound therapy (NPWT) affects the rate of wound complications when applied to women who are obese after cesarean delivery (CD) compared to standard postoperative dressings in this systematic review and meta-analysis of randomized controlled trials (RCTs).¹ This study (Prophylactic Negative Pressure Wound Therapy on Wound Complications After Cesarean Delivery in Obese Women: a Meta-Analysis of Randomized Controlled Trials) was published on March 10, 2022, with the American Journal of Obstetrics & Gynecology MFM.

The authors conducted the literature review using PubMed, Scopus, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials as digital databases. The study’s eligibility criteria only used RCTs comparing the effect on wound difficulties using NPWT vs. standard dressings in females who are obese and undergoing CD.

In the review and meta-analysis of the eleven RCTs, which included 5,746 obese women undergoing CD. Of those women, there were 2,869 (49.9%) randomized to the intervention group (NPWT) and 2,877 (50.1%) individuals randomized to the control group (standard dressing). The results of the study demonstrated that prophylactic NPWT (RR, 1.00; 95% CI, 0.81-1.23) was not linked to a substantial change in the rate of wound complications when compared with standard postoperative dressings. Though the use of NPWT did diminish the rate of wound infections (RR, 0.78; 95% CI, 0.65-0.93), while increasing the rate of skin reactions (RR, 4.59; 95% CI, 1.29-16.38). Negative pressure wound therapy did not result in a significant change in the rate of dehiscence, hematoma, seroma, readmission, reoperation, and antibiotics use for wound infection.

According to the authors, readers should be cautious when interpreting the findings, because the wound infection outcomes included different individual definitions per their own trials.

To read the full study, click here.

—Cat Urbanski, Associate Digital Editor

References

1. Angarita AM, Jayakumaran J, Di Mascio D, Berghella V. Prophylactic negative pressure wound therapy on wound complications after cesarean delivery in obese women: a meta-analysis of randomized controlled trials. Am J Obstet Gynecol MFM. 2022;100617. doi:10.1016/j.ajogmf.2022.100617