Closed-Incision Negative-Pressure Therapy in Obese Patients Undergoing Cesarean Delivery: A Randomized Controlled Trial.
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Background Postcesarean wound morbidity is a costly complication of cesarean delivery for which preventative strategies remain understudied.Objective We compared surgical site occurrences (SSOs) in cesarean patients receiving closed-incision negative-pressure therapy (ciNPT) or standard-of-care (SOC) dressing.Study Design A single-center randomized controlled trial compared ciNPT (5-7 days) to SOC dressing (1-2 days) in obese women (body mass index [BMI] ≥ 35), undergoing cesarean delivery between 2012 and 2014. Participants were randomized 1:1 and monitored 42 ± 10 days postoperatively. The primary outcome SSOs included unanticipated local inflammation, wound infection, seroma, hematoma, dehiscence, and need for surgical or antibiotic intervention.Results Of the 92 randomized patients, 82 completed the study. ciNPT and SOC groups had similar baseline characteristics. Mean BMI was 46.5 ± 6.5 and no treatment-related serious adverse events. Compared with SOC, the ciNPT group had fewer SSOs (7/43 [16.3%] vs. 2/39 [5.1%], respectively;p = 0.16); significantly fewer participants with less incisional pain both at rest (39/46 [84.8%] vs. 20/46 [43.5%];p < 0.001) and with incisional pressure (42/46 [91.3%] vs. 25/46 [54.3%];p < 0.001); and a 30% decrease in total opioid use (79.1 vs. 55.9 mg morphine equivalents,p = 0.036).Conclusion A trend in SSO reduction and a statistically significant reduction in postoperative pain and narcotic use was observed in women using ciNPT.
Published Version (Please cite this version)10.1055/s-0037-1603956
Publication InfoBrancazio, LR; Gilner, Jennifer B; Gray, BA; Gunatilake, RP; Heine, RP; Smrtka, MP; ... Thompson, JL (2017). Closed-Incision Negative-Pressure Therapy in Obese Patients Undergoing Cesarean Delivery: A Randomized Controlled Trial. AJP Rep, 7(3). pp. e151-e157. 10.1055/s-0037-1603956. Retrieved from https://hdl.handle.net/10161/16163.
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Assistant Professor of Obstetrics and Gynecology
As a clinician-scientist, I have built my career around the care of women throughout pregnancy, while simultaneously working to advance the scientific understanding of pregnancy complications such as preterm birth and placenta accreta spectrum. I have advanced training in the medical and surgical care of women with pregnancies affected by medical conditions or pregnancy-related complications, as well as basic science expertise in immunology and tolerance mechanisms of pregnancy.&nb
Associate Professor of Obstetrics and Gynecology
Dr. Geeta Swamy, MD, became Vice Chair for Research and Faculty Development in the Department of Obstetrics and Gynecology on March 1, 2018. In this dual role, Dr. Swamy oversees strategic development and administration of the Department’s basic, translational and clinical research programs, as well as implements and oversees programs to support development and mentorship for all faculty at all levels. Dr. Swamy has also been instrumental in developing and leading the School of
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