Use of Closed-Incision Negative-Pressure Therapy in Obstetrics

Background: Cesarean delivery is one of the most commonly performed surgeries in the United States. Compared with other surgical procedures, surgical site infection tends to be a relatively uncommon outcome after cesarean delivery in the general population with an incidence rate between 1.46 and 3.82% in the United States in 2006-2008. Despite this lower incidence, surgical site infections following cesarean delivery result in a 6-day increase in mean length of stay at an additional cost of $13,968. Specifically, closed-incision negative-pressure therapy (ciNPT) has been developed for use over clean, closed surgical incisions. A brief literature review on ciNPT use over cesarean delivery incisions is described. Methods: A literature search was performed using PubMed and Google Scholar. The search included publications between January 1, 2005, and April 30, 2018, and focused on studies reporting the use of a specific ciNPT system (PREVENA Incision Management System; KCI, an Acelity Company, San Antonio, TX) over cesarean incisions. Results: Five published articles were identified in the literature search that compared ciNPT use to traditional dressings. Positive clinical outcomes were reported in 2 studies, similar outcomes between ciNPT and traditional dressings were reported in 2 studies, and negative outcomes were reported in 1 study. Conclusions: A lack of published literature reporting clinical outcomes following ciNPT use over cesarean delivery incisions exists, and the currently reported evidence is heterogeneous. As such, increased published evidence from large, randomized studies and a reexamination of ciNPT use over cesarean delivery incisions are needed.