Wound management in obese women following caesarean section

Abstract

The number of obese, childbearing women is growing and causing great concerns in midwifery. Delivery via caesarean section entails the risk of developing a wound infection, or wound dehiscence. While it is essential to ensure that the care provided to women and their babies is safe, effective, individualized and based on up-to-date evidence, this may not always be the case and midwives may lack experience and appropriate training in managing these wounds. In this article, the current evidence on the impact of obesity on wound care management will be considered, along with the advice midwives should give to women after a caesarean section. The physiology of wound healing will be considered as well as the need to assess the caesarean section incision correctly by examining its appearance. Factors that affect wound healing in the obese woman and how these impact on the wound care management and advice offered by midwives will be discussed. Recommendations for midwifery practice are made throughout and include suggestions on raising awareness among staff on the impact that obesity has on wound care management and advice through training.