The effect of prophylactic negative pressure wound therapy on infection in obese women after C-section: a meta-analysis

https://doi.org/10.19106/JMedSci005501202311

Aris Widiyanto(1*), Santy Irene Putri(2), Asruria Sani Fajriah(3), Yuly Peristiowati(4), Agusta Dian Ellina(5), Joko Triatmojo(6)

(1) School of Health Sciences Mamba’ul Ulum Surakarta
(2) University of Tribhuwana Tunggadewi Malang
(3) Institute of Health Sciences Strada
(4) Institute of Health Sciences Strada
(5) Institute of Health Sciences Strada
(6) School of Health Sciences Mamba’ul Ulum Surakarta
(*) Corresponding Author

Abstract


Most caesarean wounds resulted in infection. This become a huge burden on the health care system, considering the high number of women undergoing this type of surgery. Negative pressure wound therapy (NPWT) has been recommended for a wide variety of lesions including open abdominal wounds. The purpose of this study was to investigate the effect of prophylactic NPWT on infection in obese women after a C-section. This was a systematic review and meta-analysis study that used articles from online databases of EBSCO, Google Scholar, and PubMed which published until 2022. The dependent variable was infections post C-section, while the independent were NPWT and standard wound therapy. The data was analyzed by RevMan 5.3. This study showed that there is no difference in the outcome of superficial site infection (SSI), deep site infection (DSI), wound dehiscence, seroma, and hematoma between women with obesity after caesarean delivery who used NPWT and standard dressing.


Keywords


prophylactic negative pressure; wound therapy; wound dressing; obese women; cesarean delivery

Full Text:

PDF


References

Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 2001; 25(8):1175-82.
https://doi.org/10.1038/sj.ijo.0801670
2.Poobalan AS, Aucott LS, Gurung T, Smith WC, Bhattacharya S. Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women--systematic review and meta-analysis of cohort studies. Obes Rev 2009; 10(1):28-35.
https://doi.org/10.1111/j.1467-789X.2008.00537.x
3.Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008; 9(6):635-83.
https://doi.org/10.1111/j.1467-789X.2008.00511.x
4.Denison FC, Price J, Graham C, Wild S, Liston WA. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG 2008; 115(6):720-5.
https://doi.org/10.1111/j.1471-0528.2008.01694.x
5.Denison FC, Norwood P, Bhattacharya S, Duffy A, Mahmood T, Morris C, et al. Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. BJOG 2014; 121(1):72-81; discussion 82.
https://doi.org/10.1111/1471-0528.12443
6.Voinchet V, Magalon G. [Vacuum assisted closure. Wound healing by negative pressure. Ann Chir Plast Esthet 1996; 41(5):583-9.
7.Liu S, Liston RM, Joseph KS, Heaman M, Sauve R, Kramer MS, et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 2007; 176(4):455-60.
https://doi.org/10.1503/cmaj.060870.
8.Bodner K, Wierrani F, Grünberger W, Bodner-Adler B. Influence of the mode of delivery on maternal and neonatal outcomes: a comparison between elective cesarean section and planned vaginal delivery in a low-risk obstetric population. Arch Gynecol Obstet 2011; 283(6):1193-8.
https://doi.org/10.1007/s00404-010-1525-y
9.Johnson A, Young D, Reilly J. Caesarean section surgical site infection surveillance. J Hosp Infect 2006; 64(1):30-5.
https://doi.org/10.1016/j.jhin.2006.03.020
10.Vincent A, Ayzac L, Girard R, Caillat-Vallet E, Chapuis C, Depaix F, et al. Downward trends in surgical site and urinary tract infections after cesarean delivery in a French surveillance network, 1997-2003. Infect Control Hosp Epidemiol 2008; 29(3):227-33.
https://doi.org/10.1086/527512
11.Ward VP, Charlett A, Fagan J, Crawshaw SC. Enhanced surgical site infection surveillance following caesarean section: experience of a multicentre collaborative post-discharge system. J Hosp Infect 2008; 70(2):166-73.
https://doi.org/10.1016/j.jhin.2008.06.002
12.Szilágyi E, Füzi M, Böröcz K, Kurcz A, Tóth Á, Nagy K. Risk factors and outcomes for bloodstream infections with extended-spectrum β-lactamase-producing Klebsiella pneumoniae; Findings of the nosocomial surveillance system in Hungary. Acta Microbiol Immunol Hung 2009; 56(3):251-62.
https://doi.org/10.1556/AMicr.56.2009.3.5
13.Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg 2017; 152(8):784-91.
https://doi.org/10.1001/jamasurg.2017.0904
14.Dias M, Dick A, Reynolds RM, Lahti-Pulkkinen M, Denison FC. Predictors of surgical site skin infection and clinical outcome at caesarean section in the very severely obese: A retrospective cohort study. PLoS One 2019; 14(6):e0216157.
https://doi.org/10.1371/journal.pone.0216157
15.Ramírez-Wong FM, Atencio-Espinoza T, Rosenthal VD, Ramirez E, Torres-Zegarra SL, Díaz Tavera ZR, et al. Surgical Site Infections Rates in More Than 13,000 Surgical Procedures in Three Cities in Peru: Findings of the International Nosocomial Infection Control Consortium. Surg Infect (Larchmt) 2015; 16(5):572-6.
https://doi.org/10.1089/sur.2014.201
16.Norman G, Goh EL, Dumville JC, Shi C, Liu Z, Chiverton L, et al. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane database Syst Rev 2020; 5(5):CD009261.
https://doi.org/10.1002/14651858.CD009261
17.Smyth ETM, McIlvenny G, Enstone JE, Emmerson AM, Humphreys H, Fitzpatrick F, et al. Four country healthcare associated infection prevalence survey 2006: overview of the results. J Hosp Infect 2008; 69(3):230-48.
https://doi.org/10.1016/j.jhin.2008.04.020
18.Wloch C, Wilson J, Lamagni T, Harrington P, Charlett A, Sheridan E. Risk factors for surgical site infection following caesarean section in England: results from a multicentre cohort study. BJOG 2012; 119(11):1324-33.
https://doi.org/10.1111/j.1471-0528.2012.03452.x
19.Norman G, Goh EL, Dumville JC, Shi C, Liu Z, Chiverton L, et al. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane database Syst Rev 2020; 5(5):CD009261.
https://doi.org/10.1002/14651858.CD009261
20.Hyldig N, Vinter CA, Kruse M, Mogensen O, Bille C, Sorensen JA, et al. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial. BJOG 2019; 126(5):628-35.
https://doi.org/10.1111/1471-0528.15413
21.Ubbink DT, Westerbos SJ, Nelson EA, Vermeulen H. A systematic review of topical negative pressure therapy for acute and chronic wounds. Br J Surg 2008; 95(6):685-92.
https://doi.org/10.1002/bjs.6238
22.Vikatmaa P, Juutilainen V, Kuukasjärvi P, Malmivaara A. Negative pressure wound therapy: a systematic review on effectiveness and safety. Eur J Vasc Endovasc Surg 2008; 36(4):438-48.
https://doi.org/ 0.1016/j.ejvs.2008.06.010
23.Medicine JH. Surgical Site Infections. Health. 2021.
24.Gillespie BM, Webster J, Ellwood D, Thalib L, Whitty JA, Mahomed K, et al. Closed incision negative pressure wound therapy versus standard dressings in obese women undergoing caesarean section: multicentre parallel group randomised controlled trial. BMJ 2021; 373:n893.
https://doi.org/10.1136/bmj.n893
25.Tuuli MG, Liu J, Tita ATN, Longo S, Trudell A, Carter EB, et al. Effect of prophylactic negative pressure wound therapy vs standard wound dressing on surgical-site infection in obese women after cesarean delivery: A randomized clinical trial. JAMA 2020; 324(12):1180-9.
https://doi.org/ 10.1001/jama.2020.13361
26.Wihbey KA, Joyce EM, Spalding ZT, Jones HJ, MacKenzie TA, Evans RH, et al. Prophylactic Negative Pressure Wound Therapy and Wound Complication after Cesarean Delivery in Women with Class II or III Obesity: A Randomized Controlled Trial. Obstet Gynecol 2018; 132(2):377-84.
https://doi.org/10.1097/AOG.0000000000002744
27.Gouttefangeas C, Eberle M, Ruck P, Stark M, Müller JE, Becker HD, et al. Functional T lymphocytes infiltrate implanted polyvinyl alcohol foams during surgical wound closure therapy. Clin Exp Immunol 2001; 124(3):398-405.
https://doi.org/10.1046/j.1365-2249.2001.01547.x
28.Chen SZ, Li J, Li XY, Xu LS. Effects of vacuum-assisted closure on wound microcirculation: An experimental study. Asian J Surg 2005; 28(3):211-7.
https://doi.org/10.1016/S1015-9584(09)60346-8
29.Malmsjö M, Gustafsson L, Lindstedt S, Gesslein B, Ingemansson R. The effects of variable, intermittent, and continuous negative pressure wound therapy, using foam or gauze, on wound contraction, granulation tissue formation, and ingrowth into the wound filler. Eplasty 2012; 12:e5.
30.Xia CY, Yu AX, Qi B, Zhou M, Li ZH, Wang WY. Analysis of blood flow and local expression of angiogenesis-associated growth factors in infected wounds treated with negative pressure wound therapy. Mol Med Rep 2014; 9(5):1749-54.
https://doi.org/ 10.3892/mmr.2014.1997
31.Greif R, Akça O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med 2000; 342(3):161-7.
https://doi.org/10.1056/NEJM200001203420303
32.Allen DB, Maguire JJ, Mahdavian M, Wicke C, Marcocci L, Scheuenstuhl H, et al. Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 1997; 132(9):991-6.
https://doi.org/10.1001/archsurg.1997.01430330057009
33.Costa ML, Achten J, Knight R, Bruce J, Dutton SJ, Madan J, et al. Effect of incisional negative pressure wound therapy vs standard wound dressing on deep surgical site infection after surgery for lower limb fractures associated with major trauma: The WHIST Randomized Clinical Trial. JAMA 2020; 323(6):519-26.
https://doi.org/10.1001/jama.2020.0059
34.Smid MC, Dotters-Katz SK, Grace M, Wright ST, Villers MS, Hardy-Fairbanks A, et al. Prophylactic negative pressure wound therapy for obese women after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol 2017; 130(5):969-78.
https://doi.org/0.1097/AOG.0000000000002259
35.Widiyanto A, Putri SI, Fajriah AS, Rejo R, Nurhayati I, Yuniarti T, et al. The implementation of family nursing care to patients with chronic diseases: a systematic review. STRADA: Jurnal Ilmiah Kesehatan 2021; 10(1):1225-33.
https://doi.org/10.30994/sjik.v10i1.753



DOI: https://doi.org/10.19106/JMedSci005501202311

Article Metrics

Abstract views : 1281 | views : 1046


Bookmark and Share


Copyright (c) 2023 Aris Widiyanto - Santy Irene Putri - Asruria Sani Fajriah - Yuly Peristiowati - Agusta Dian Ellina - Joko Triatmojo

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.