![]() This paper also studies the effect of NPWT on SSI incidence depending upon the type of C-section (elective/emergency) and the NPWT system or device used and includes all RCTs published until December 2022. However, NPWT also seen to have a favourable effect on other wound complications such as dehiscence, haematoma, seroma, and disruption. In accordance with some previous meta-analyses, the current meta-analysis shows the beneficial effect of NPWT in reducing the incidence of SSI when applied to post-surgical incisions and used prophylactically in obese women undergoing C-sections. The present study provides current information on the efficacy of NPWT systems in reducing the incidence of SSIs and wound complications in women undergoing C-section procedures. ![]() However, there was no significant subgroup effect (p = 0.20). Stratification by the device type used showed that the negative pressure system caused a significant decrease in SSI outcome when the PICO system was used (RR = 0.72, 0.58–0.91, p = 0.006, I2 = 0%), whereas there was no significant difference in SSI incidence when the PREVENA system was used versus standard wound dressing (RR = 0.94, 0.68–1.29, p = 0.69, I2 = 0%) (Figure 7). Subgroup analysis was also performed by the type of NPWT system used. It is of value to note that there was only one study that studied the effect of NPWT in emergency caesarean sections. The test for subgroup differences indicated no statistically significant subgroup difference (p = 0.97), indicating that the type of surgery does not influence the response to NPWT. ![]() However, there was no significant difference in SSI rates between the NPWT and standard dressing groups when subdivided by the type of caesarean section with all types showing no significant difference between the NPWT and standard dressing groups (Figure 6). Stratification of the results by the type of caesarean section (emergency/elective/mixed) showed an overall significant decrease in SSI incidence following NPWT treatment over the standard wound dressing (RR = 0.79, 0.66 to 0.95, p = 0.01, I2 = 0%). Forest plots were constructed and p 30 kg/m2 indicating obesity). A three-fold increase in cost associated with post-caesarean SSI compared to a non-infected matched control group (p 50%. A prospective observational study conducted in north India reported an SSI rate of 10.3 per 100 procedures, with superficial SSIs (66.7%) being the most common sub-type. The reported incidence of SSI following C-section ranges from 3% to 15%, causing a physical and emotional burden on the mother as well as significant healthcare-associated financial implications. Complications accompanying C-section births include maternal infectious morbidity, with SSIs being most prevalent as compared to vaginal deliveries. Ĭaesarean section (C-section) procedures are becoming increasingly prevalent with a global incidence of 1 in 5 childbirths as of 2021 with a projected increase to almost a third of all births by 2030 according to WHO estimates. These strategies can be used during the preoperative, intraoperative, or postoperative phases depending upon the surgery type and surgeon preference and have been recommended by the World Health Organization (WHO) at differing recommendation levels based on the strength of gathered evidence. Methods to minimize the occurrence of SSI include the use of infection control measures such as antimicrobial prophylaxis, operating room ventilation, sterilization methods, barriers and drapes, surgical techniques, maintenance of patient homeostasis, and surveillance programmes by surgeons. SSIs are associated with increased morbidity, extended hospitalization stays, and mortality in addition to a significant financial burden on patients and payers due to extended hospitalization stays, treatment costs, and in some cases reoperations. The Centers for Disease Control (CDC) have categorized SSIs depending upon the extent of penetration into the skin or tissues as superficial SSI (involving only the skin or subcutaneous tissue), deep incisional SSI (involving deep soft tissues of an incision), and infections involving organs or body spaces. The global prevalence of SSIs is 0.5–15% with a higher prevalence of up to 38% in developing and low-middle-income countries such as India. Surgical site infections (SSI) occur at the site where surgery is performed in the post-operative period and account for an estimated 22% of all healthcare-associated infections.
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