1. EP228 STANDARD DRESSING OR NPTW: WHICH ONE REDUCES THE RISK OF SURGICAL SITE INFECTION IN OBESE WOMEN UNDERGOING CAESAREAN SECTION?
- Author
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Occhipinti, Martina
- Subjects
PREVENTION of surgical complications ,OBESITY ,META-analysis ,CONFERENCES & conventions ,NEGATIVE-pressure wound therapy ,SURGICAL site infections ,CESAREAN section - Abstract
Aim: To summarize available meta-analysis on the effectiveness of Negative-Pressure Wound Therapy (NPWT) for preventing surgical site infections (SSI, primary outcome) and other wound complications (incidence of seroma, bleeding, dehiscence of the wound, need for readmission and re-operation) in obese women (BMI>=30kg/m2) undergoing cesarean section (CS) compared to a standard dressing. Method: We systematically searched PubMed using Mesh terms and found 3 meta-analysis and systematic reviews published from 2017 to 2021. Results: Based on the evaluation of 2 meta-analysis, the use of NPWT systems is associated with a statistically significant reduction of SSI (RR 0.79, 95% CI 0.65-0.95, p<0.01) with a moderate grade quality categorization (RR =0,68, IC 95% = 0,51--0,90, p = 0,008). According to the oldest meta-analysis there was no statistically significant difference between the two groups (RR 0,97, IC 95% 0,63-1,49) but the quality of the studies was judged lower. The secondary outcomes of all the evaluated meta-analysis were not found statistically significant. Conclusion: The prevention of ISS must be a priority for health professionals. Considering the cost-effectiveness of NPWT, also the Cochrane review of 2022 and the Nice guideline on Cesarean Section of 2021 suggest using NPWT on obese women undergoing CS, establishing as recommended BMI above 35 kg/m2 as a surgical indication to prevent ISS. However, all the authors agree on conducting new RCTs in order to be able to ponder on clinical choices also on the basis of the main limit of this type of dressing: its economic impact. [ABSTRACT FROM AUTHOR]
- Published
- 2023