Closed Incision Negative Pressure Wound Therapy Versus Standard Dressings In Obese Women Undergoing Caesarean Section: Multicentre Parallel Group Randomised Controlled Trial

OBJECTIVE To determine the effectiveness of closed incision negative pressure wound therapy (NPWT) compared with standard dressings in preventing surgical site infection (SSI) in obese women undergoing caesarean section. DESIGN Multicentre, pragmatic, randomised, controlled, parallel group, superiority trial. SETTING Four Australian tertiary hospitals between October 2015 and November 2019. PARTICIPANTS Eligible women had a pre-pregnancy body mass index of 30 or greater and gave birth by elective or semi-urgent caesarean section. INTERVENTION 2035 consenting women were randomised before the caesarean procedure to closed incision NPWT (n=1017) or standard dressing (n=1018). Allocation was concealed until skin closure. MAIN OUTCOME MEASURES The primary outcome was cumulative incidence of SSI. Secondary outcomes included depth of SSI (superficial, deep, or organ/body space), rates of wound complications (dehiscence, haematoma, seroma, bleeding, bruising), length of stay in hospital,