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Best Pract Res Clin Obstet Gynaecol. 2015 Apr;29(3):406-14. doi: 10.1016/j.bpobgyn.2014.08.009. Epub 2014 Oct 16.

Obesity and the challenges of caesarean delivery: prevention and management of wound complications.

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1
Medical School - S. João Hospital, University of Porto, Institute of Biomedical Engineering, Porto, Portugal. Electronic address: dcampos@med.up.pt.

Abstract

Caesarean section in obese patients is associated with an increased risk of surgical wound complications, including haematoma, seroma, abscess and dehiscence. This review focusses on the available strategies to decrease wound complications in this population, and on the clinical management of these situations. Appropriate dose of prophylactic antibiotics, closure of the subcutaneous tissue, and avoidance of subcutaneous drains reduce the incidence of wound complications associated with caesarean section in obese patients. For treatment of superficial wound infection associated with dehiscence, there are data from general surgery patients to suggest that the use of vacuum-assisted devices leads to faster healing and that surgical reclosure is preferable to healing by secondary intention, when there are no signs of ongoing infection. There is a need for stronger evidence regarding the prevention and management of wound complications for caesarean section in obese women.

KEYWORDS:

body mass index; caesarean section; obesity; post-operative complications; pregnancy; surgical wound infection

PMID:
25457856
DOI:
10.1016/j.bpobgyn.2014.08.009
[Indexed for MEDLINE]
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