Abstract
Introduction and aims of the study: The increasing number of caesarean sections worldwide1 makes impaired healing of wounds after the procedure a frequent problem. Assessed risk of surgical site infections (SSI) is about 2-15% and 90% of them are superficial SSI. 2 Closed incision Negative Pressure Wound Therapy (NPWT) is a method under evaluation mainly in obese women undergoing caesarean deliveries with discrepant results. From the ones stating that NWPT vacuum dressings are efficient3 to the ones claiming that prophylactic usage in obese women did not reduce the incidence of SSIs. 4 The aim of the study was to evaluate wound healing outcomes in high-risk patients after caesarean section treated with and without the use of NPWT. Methods: In 2019 we prepared a list of identifiable risk factors of inappropriate wound healing. When a patient history confirmed at least 3 risk factors, we used prophylactic NPWT for 5 days (V.A.C. dressing). Patients data were retrospectively analysed. Group 1 were patients with NPWT from 2020 to march of 2021. A control group was created from patients data from the same time frame (hospital database), matching the intervention group for age, BMI and risk factors of SSIs. Outcomes assessed were the presence of wound complications, need for antibiotic therapy, readmission to hospital, length of stay and additional surgical procedures. Results: Patients in both the intervention group (n=21) and control group (n=6323) were included to the study. There was only one inappropriate wound healing in the intervention group. Moreover, usage of VAC was connected with shorter hospital stay, with no readmission to hospital and fewer antibiotic therapies and additional surgical procedures in comparison to control group. Conclusion: Closed incision NWPT is effective way of SSIs prophylaxis when proper qualification to intervention. More studies are needed, especially prospective ones, with the bigger study sample.
Published Version
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