Evaluating Closed Incision Negative Pressure Therapy Use Following High-Risk Caesarean Section in a Middle East...

Surgical site complications (SSCs) following caesarean section impact maternal morbidity and mortality. To mitigate SSC development, incision management strategies such as closed incision negative pressure therapy (ciNPT) can be utilised. The effect of ciNPT on the management of closed incisions following caesarean section was examined in the present study. Patients underwent caesarean section between 2022 and 2024 at a single acute care hospital in the United Arab Emirates (UAE). All 82 patients underwent vaginal cleansing and received antibiotics prior to surgery. A Pfannenstiel incision was used, followed by closure with subcuticular suturing. Patients received either traditional silver dressings (Mepilex Border Ag Dressing; Mölnlycke Health Care, Peachtree Corners, USA) (standard of care (SOC) group, n=28) or ciNPT (3M Prevena Incision Management System; Solventum, Maplewood, USA) (ciNPT group, n=54) for postoperative care. Patient and incision outcomes were assessed at each dressing change. Welch two-sample t-tests compared continuous variables, and Fisher's exact tests compared categorical variables. There were no significant differences between the ciNPT and SOC groups for baseline demographics; however, the ciNPT group had a higher proportion of severely obese patients (body mass index (BMI) >40 kg/m²) and patients who had two or more previous caesarean deliveries. The ciNPT group had a lower SSC rate compared to the SOC group (0/54 (0%) vs. 6/28 (21%), respectively; p=0.0011), as well as a lower number of surgical site infections (SSIs) (0/54 (0%) vs. 3/28 (11%); p=0.037) and deep infections (0/54 (0%) vs. 3/28 (11%); p=0.037). In this patient population, the use of ciNPT was well tolerated and may help improve clinical outcomes in high-risk patients undergoing caesarean delivery.