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A randomized trial of cesarean wound coverage: Exposed compared with dressed

BJOG: An International Journal of Obstetrics and Gynaecology Mar 29, 2020

Tan PC, et al. - Researchers performed randomized trial investigating the superficial surgical site infection (SSI) rate to 28 days and patient satisfaction with wound coverage management when their transverse suprapubic cesarean wound is left exposed compared with dressed after skin closure. At University Hospital, Malaysia: April 2016‐October 2016, randomization of 331 women delivered by cesarean section was done to leaving their wound entirely exposed (n = 165) or dressed (n = 166) with a low adhesive dressing (next day removal). Exposed vs dressed arms had superficial SSI rates of 2/153(1.3%) vs 5/157(3.2%) and patient satisfaction with wound management of 7[5‐8] vs 7[5‐8], respectively. In the wound‐exposed arm, significant increase in stated preference for wound exposure was observed from 35.5% to 57.5% whereas in the wound‐dressed arm, reduction in the stated preference for a dressed wound was observed from 48.5% to 34.4% when assessed at recruitment (prerandomization) to at Day 28. Although the trial is underpowered due to lower SSI rates than expected, cesarean wounds left exposed seems to have no detrimental effects, provided patient counseling to manage expectations is undertaken.

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