Early wound dressing removal after scheduled cesarean delivery: a randomized controlled trial

Peleg, David; Eberstark, Esther; Warsof, Steven L.; Cohen, Nadav; Shachar, Inbar Ben

doi:10.1016/j.ajog.2016.03.035

Cited by 33 publications

(27 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Vigorous coughing or severe hypertension immediately after surgery may contribute to the formation of hematoma. Wound hematoma or seroma, described in 2-5% of women after CD can cause wound dehiscence and act as a nidus for development of wound infection [6, 7]. Wound dehiscence is separation of incision and complicates 2-7% after CD [6, 7].…”

Section: Epidemiologymentioning

confidence: 99%

“…In a group of women who underwent scheduled CD, Peleg et al in 2016 conducted a randomized controlled trial comparing postoperative dressing removal at 6 h ( n = 160) with dressing removal at 24 h ( n = 160) and showed no difference in wound complications [7]. However, the women with earlier dressing removal were more pleased or satisfied than those with later dressing removal (OR 2.35; 95% CI 1.46, 3.79).…”

Section: Postoperative Managementmentioning

confidence: 99%

See 1 more Smart Citation

Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

Kawakita

Landy

2017

matern health, neonatol and perinatol

161

105

View full text Add to dashboard Cite

Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD – 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution. Effective interventions to decrease surgical site infection include prophylactic antibiotic use (preoperative first generation cephalosporin and intravenous azithromycin), chlorhexidine skin preparation instead of iodine, hair removal using clippers instead of razors, vaginal cleansing by povidone-iodine, placental removal by traction of the umbilical cord instead of by manual removal, suture closure of subcutaneous tissue if the wound thickness is >2 cm, and skin closure with sutures instead of with staples. Implementation of surgical bundles in non-obstetric patients has been promising., Creating a similar patient care bundle comprised evidence-based elements in patients who undergo CD may decrease the incidence of this major complication. Each hospital has the opportunity to create its own CD surgical bundle to decrease surgical site infection.

show abstract

Section: Epidemiologymentioning

confidence: 99%

Section: Postoperative Managementmentioning

confidence: 99%

Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

Kawakita

Landy

2017

matern health, neonatol and perinatol

161

105

View full text Add to dashboard Cite

show abstract

“…Due to the nature of clinical practice in our facility, patients are followed up postoperatively in the community health clinics and not seen by the hospital physicians. To overcome this limitation, we obtained information about wound healing via standardized telephone interviews and found the rate of CD wound healing problems was in accordance with the current medical literature …”

Section: Discussionmentioning

confidence: 91%

“…Prevalence of cesarean delivery (CD) has been rising in the last decade and has reached 25%–50% of all deliveries . Although major wound complications after CD are relatively rare, affecting only 6%–13% of patients, minor complications, estimated to occur in about 25% of cases, constitute important factors impacting the puerperium, including length of admission, ability to care for the newborn, and scar appearance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

Heinemann

Solnica

Abdelkader

et al. 2019

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To investigate optimal timing of dressing and staples removal after cesarean delivery (CD). Methods This prospective clustered clinical trial enrolled women undergoing CD between January 1, 2013, and October 31, 2014, at Hadassah–Hebrew University Hospital, Jerusalem. Women were assigned to one of five clusters differing in timing of dressing and staples removal. We assessed scar healing at 6 weeks. Results 920 women completed telephone questionnaires. Wound healing did not differ significantly among the clusters: the healing complication rate was 21% in the control group (n=46) and ranged from 18% to 26% (n=27–50) in clusters two to five (P=0.49). More healing complications were observed in women with a body mass index (BMI) of more than 35 kg/m2 versus 35 kg/m2 or less (P=0.016), urgent versus elective CD (P=0.013), preterm premature rupture of the membranes (PPROM) versus intact membranes (P=0.016), and chorioamnionitis at delivery versus no chorioamnionitis (P=0.001). 586 (64%) women underwent physician assessment at staples removal and at 6 weeks post CD. Conclusions Timing of dressing and staples removal has no effect on CD scar healing in low‐ and high‐risk parturients. A BMI of more than 35 kg/m2, urgent CD, PPROM, and chorioamnionitis were associated with mal‐healing, regardless of cluster. Clinicaltrials.gov: NCT01724255.

show abstract

A systematic review with meta‐analysis on prophylactic negative pressure wound therapy versus standard dressing for obese women after caesarean section

Tian

Ling

2023

Nursing Open

View full text Add to dashboard Cite

AimsThe purpose of this study is to assess the efficacy of prophylactic negative pressure wound therapy (NPWT) in obese women undergoing caesarean section.DesignAn updated review and meta‐analysis of randomized controlled trials following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.MethodsPubMed, Embase, Medline, Web of Science, and Cochrane Library were searched from inception up to March 2022 without restriction in language. We chose surgical site infection as the primary outcome.ResultsNPWT resulted in a lower surgical site infection rate compared with conventional dressing (risk ratio [RR] = 0.76). The infection rate after low transverse incision was lower comparing the NPWT group with the control group ([RR] = 0.76). No statistically significant difference was detected in blistering([RR] = 2.91). The trial sequential analysis did not support the 20% relative decrease in surgical site infection in the NPWT group. (type II error of 20%).

show abstract

Early wound dressing removal after scheduled cesarean delivery: a randomized controlled trial

Cited by 33 publications

References 8 publications

Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

Timing of staples and dressing removal after cesarean delivery (the SCARR study)

A systematic review with meta‐analysis on prophylactic negative pressure wound therapy versus standard dressing for obese women after caesarean section

Contact Info

Product

Resources

About