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Am J Perinatol 2017; 34(11): 1125-1130
DOI: 10.1055/s-0037-1604161
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prophylactic Wound Vacuum Therapy after Cesarean Section to Prevent Wound Complications in the Obese Population: A Randomized Controlled Trial (the ProVac Study)

Kelly Ruhstaller
1   Department of Obstetrics and Gynecology, Maternal Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Katheryne L. Downes
1   Department of Obstetrics and Gynecology, Maternal Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Suchitra Chandrasekaran
2   Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
,
Sindhu Srinivas
1   Department of Obstetrics and Gynecology, Maternal Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Celeste Durnwald
1   Department of Obstetrics and Gynecology, Maternal Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

16 May 2017

05 June 2017

Publication Date:
13 July 2017 (online)

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Abstract

Objective The objective of this study was to perform a randomized controlled feasibility trial investigating negative pressure wound therapy (NPWT) system versus a standard postcesarean wound care (WC) on the development of a postoperative surgical site infection (SSI) and/or a wound dehiscence in obese women.

Study Design This is a randomized controlled feasibility trial of obese women undergoing an unscheduled cesarean delivery. Women with an initial body mass index ≥ 30 kg/m2 who were ≥ 4 cm dilated were included. Women were assigned to either a NPWT or standard WC. The primary outcome was a composite of wound morbidity at 4 weeks postpartum including SSI and/or wound opening (clinicaltrials.gov, NCT02128997). Continuous variables were analyzed with t-test and Wilcoxon rank-sum tests and categorical variables with Fisher's exact test.

Results Of 136 women randomized, 67 received NPWT and 69 received standard WC. The 4-week follow-up rate was 88%. Maternal clinical and surgical characteristics were similar between the groups. The prevalence of the composite wound morbidity outcome was not different between those with NPWT and standard WC (4.9 vs. 6.9%; p = 0.71).

Conclusion Routine clinical use of a NPWT system after cesarean delivery did not result in a significant reduction of wound morbidity over standard WC.

Keywords

cesarean delivery - negative pressure wound therapy - obese - surgical site infection - wound complication

Note

This study was presented at the 37th Annual Meeting of the Society for Maternal Fetal Medicine, Las Vegas, NV, January 25–27, 2017.


Clinical Trials Registration

The clinical trial was registered at https://clinicaltrials.gov/, NCT02128997.