Abstract
Objective To determine whether the use of external negative pressure dressing system (ENPDS)
can reduce the incidence of wound complications after cesarean delivery (CD) compared
with traditional dressings.
Methods Retrospective review of all patients undergoing CD between November 2011 and March
2013. Information was collected on demographics, body mass index (BMI), duration of
labor, pre- and postnatal infections, incision and dressing type, and postoperative
course. Comparisons were made between traditional dressing and an external negative
pressure dressing system.
Results Of 970 patients included in the study, wound complications occurred in 50 patients
(5.2%). Comparisons of ENPDS (n = 103) and traditional dressing (n = 867) groups revealed higher wound complications for ENPDS with odds ratio (OR)
3.37 and confidence interval (CI) 1.68 to 6.39. ENPDS was more commonly used in patients
with BMI > 30 and preexisting diabetes. After controlling for BMI and pregestational
diabetes in logistic regression analysis, ENPDS was equivalent to traditional dressing
for risk of wound complications with an adjusted OR 2.76 (CI 0.97 to 7.84), with a
trend toward more wound complications with ENPDS. Wound separation also tended to
be more common in ENPDS group versus traditional dressing with an adjusted OR 2.66
(CI 0.87 to 8.12), although this result did not reach significance.
Conclusion ENPDS is equivalent to traditional dressing for preventing wound complications after
controlling for the higher-risk population selected for its use. In particular, wound
separation appears to occur more frequently in women treated with ENPDS versus traditional
dressing and should be regarded as a potential hazard of the system.
Keywords
negative pressure - wound therapy - cesarean delivery - cesarean section
