03538nam a22003377a 4500008004200000022001400042024004000056040002000096245012500116251006900241252005100310253023700361260000900598260001100607265001700618266001500635501006300650520031500713520039501028520054701423520090401970546001202874650003402886651003902920656005402959657002003013700001803033700002203051700002403073856010303097190521s20192019 xxu||||| |||| 00| 0 eng d a1476-4954 a10.1080/14767058.2019.1611774 [doi] aOvid MEDLINE(R) aNegative pressure wound therapy system in extremely obese women after cesarean delivery compared with standard dressing. aJournal of Maternal-Fetal & Neonatal Medicine. :1-5, 2019 May 05 aJ Matern Fetal Neonatal Med. :1-5, 2019 May 05 aThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians c2019 fFY2019 saheadofprint d2019-05-21 aAvailable online through MWHC library: 2013 to the present aCONCLUSION: In extremely obese women undergoing cesarean delivery, prophylactic PICO NPWT was not associated with a decreased risk of the primary outcome compared with standard dressings. A large prospective randomized controlled trial would be useful to answer if NPWT is beneficial for extremely obese women. aOBJECTIVE: Data regarding the use of the negative pressure wound therapy (NPWT) system in extremely obese women (body mass index [BMI] >= 50 kg/m2) undergoing cesarean delivery are limited. We sought to examine the rate of wound complications in extremely obese women according to postcesarean dressings (NPWT [PICO, Smith & Nephew, St. Peterburg, FL] versus standard dressings). aRESULTS: Of 179 extremely obese women, 73 (40.8%) and 106 (59.2%) received NPWT and standard dressings, respectively; 61 women who received NPWT were matched to 61 women who received standard dressings. The rates of the primary outcome in the unmatched cohort were similar between women who received NPWT and those who received standard dressings (20.6 versus 16.0%; p = .44). The rates of primary outcome remained similar between women who received NPWT and those who received standard dressings after matching (18.0 versus 18.0%; p = 1.00). aSTUDY DESIGN: This was a retrospective cohort study of all extremely obese women (BMI >= 50 kg/m2) at 23 weeks' gestation or greater who underwent cesarean delivery at an academic teaching hospital in Washington, DC, between January 2009 and September 2017. During this period, a PICO Single Use NPWT system was used at our institution. Women who missed a postpartum follow-up were excluded. Since 2014, Medstar Washington Hospital Center recommended the use of a PICO Single Use NPWT system for extremely obese women at the time of delivery. However, the ultimate decision to use the NPWT was made by attending physicians, considering the cost of the device and the risk of wound complication. Our primary outcome was a composite of cellulitis, hematoma/seroma, and wound dehiscence. Coarsened exact matching with k-to-k solution was performed using BMI, rupture of membranes, and labor. aEnglish aIN PROCESS -- NOT YET INDEXED aMedStar Washington Hospital Center aObstetrics and Gynecology/Maternal-Fetal Medicine aJournal Article aIqbal, Sara N aKawakita, Tetsuya aOvercash, Rachael T uhttps://dx.doi.org/10.1080/14767058.2019.1611774zhttps://dx.doi.org/10.1080/14767058.2019.1611774