ADding negative pRESSure to improve healING (the DRESSING trial): a RCT protocol.

Area of Science:

• Obstetrics and Gynecology
• Surgical Innovation
• Public Health

Background:

• Obese women face higher surgical site infection (SSI) risks after caesarean sections (CS).
• Negative pressure wound therapy (NPWT) shows potential for SSI reduction, but evidence is limited.
• Evaluating NPWT's effectiveness in obese CS patients is crucial for improving outcomes.

Purpose of the Study:

• To assess the clinical and cost-effectiveness of NPWT for obese women undergoing elective and semi-urgent CS.
• To provide evidence-based recommendations for SSI prevention strategies in this high-risk population.

Main Methods:

• A pragmatic, superiority, parallel randomised controlled trial involving 2090 obese women (BMI ≥ 30) undergoing CS.
• Participants were randomised 1:1 to NPWT or standard dressings.
• Primary outcome: SSI. Secondary outcomes: wound complications, length of stay, quality of life. Economic evaluation included cost-effectiveness.

Main Results:

• The study is currently in the pre-results phase.
• Data collection and analysis are ongoing.
• Results will determine NPWT's impact on SSI rates and healthcare costs.

Conclusions:

• The findings will inform clinical practice regarding NPWT use in obese women post-CS.
• This research aims to optimize wound management and reduce SSI burden.
• Evidence generated will guide future healthcare resource allocation for maternal surgical care.