The Use of the Prevena™ Incision Management System on Post-Surgical Cesarean Section Incisions
Post-operative Complications, Surgical Site Infection, Surgical Wound Infection
About this trial
This is an interventional supportive care trial for Post-operative Complications focused on measuring surgical site infection, nosocomial infection, post-operative complication, surgical incision risk, surgical incision infection, negative pressure wound therapy, wound management, cesarean section surgery, wound dehiscence, wound infection, surgical closure, wound disruption, subcutaneous approximation, wound separation, seroma, hematoma, subcutaneous closure, obesity, cesarean, incision, massive obesity, obese, pregnancy, cesarean delivery, superobesity, wound complication
Eligibility Criteria
Inclusion Criteria:
The Subject:
- is a female aged ≥ 18 years
- is able to provide her own informed consent
- will undergo a Cesarean section procedure using a subcuticular skin closure technique within the next 42 days
- will require a surgical incision able to be covered completely by the PIMS skin interface
- has a BMI ≥ 35 kg/m2 as determined during the Screening Period up to 42 days pre-surgery
is preoperatively assessed to undergo a procedure with a CDC Wound Classification of:
Class I (Clean): An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered
- OR -
- Class II (Clean Contaminated): An operative wound in which the respiratory, alimentary, genital, or uninfected urinary tract are entered under controlled conditions and without unusual contamination
- is willing and able to return for all scheduled and required study visits
- is not concurrently enrolled in another clinical intervention trial which may impact maternal health or the surgical site
Exclusion Criteria:
The Subject:
- is ASA Class P4, P5, or P6 (Appendix F - American Society of Anesthesiologists (ASA) Physical Status Classification System)
- has a systemic bacterial or fungal infection at the time of surgery
- has a remote-site skin infection at the time of surgery
- has a life expectancy of < 12 months
is preoperatively assessed to undergo a procedure with a CDC Wound Classification of:
Class III (Contaminated): Open, fresh, accidental wounds, and/or major breaks in sterile technique or gross spillage from the gastrointestinal tract
- OR -
- Class IV (Dirty-Infected): Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera
- experiences intraoperative hemorrhage requiring transfusion, disseminated-intravascular coagulopathy (DIC) or other medical or surgical condition during the Cesarean section deemed by the investigator to pose a prohibitively high risk for surgical re-exploration
- who, in the investigator's opinion, would have any clinically significant condition that would impair the participant's ability to comply with the study procedures
- has a known allergy or hypersensitivity to silver, or drape materials that contain acrylic adhesives
Sites / Locations
- Duke University Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standard Dressing
Prevena™ (PIMS)
Standard-of-care includes coverage of the sutured incision with sterile gauze and non-penetrable barrier (e.g., Tegaderm™) consistent with the national standard for dressing Cesarean section incisions.
PIMS unit is a single patient use, battery-powered, disposable unit that can provide continuous -125 mmHg negative pressure over a 7-day therapy period.