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Predictors of surgical site skin infection and clinical outcome at caesarean section in the very severely obese: A retrospective cohort study

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  • Michael Dias
  • Allyn Dick
  • Rebecca M Reynolds
  • Marius Lahti-Pulkkinen
  • Fiona C Denison

Abstract

Introduction: The optimal surgical approach for caesarean section is uncertain in women with very severe obesity (body mass index (BMI) >40kg/m2). We aimed to assess maternal and surgical predictors of surgical site skin infection (SSSI) in very severely obese women and to undertake an exploratory evaluation of clinical outcomes in women with a supra-panniculus transverse compared to an infra-panniculus transverse skin incision. Material and methods: Using a retrospective cohort design, case-records were reviewed of very severely obese women with a singleton pregnancy delivered by caesarean between August 2011 and December 2015 (n = 453) in two maternity hospitals in Scotland. Logistic regression analysis was used to determine predictors for SSSI. Outcomes were compared between women who had a supra-panniculus transverse compared to infra-panniculus transverse skin incision. Results: Lower maternal age was predictive of SSSI, with current smoking status and longer wound open times being marginally significant. Maternal BMI, suture method and material demonstrated univariate associations with SSSI but were not independent predictors. Women with a supra-panniculus transverse skin incision were older (32.9 (4.4), vs. 30.6 (5.7), p = 0.002), had higher BMI (49.2 (7.1), vs. 43.3 (3.3), p

Suggested Citation

  • Michael Dias & Allyn Dick & Rebecca M Reynolds & Marius Lahti-Pulkkinen & Fiona C Denison, 2019. "Predictors of surgical site skin infection and clinical outcome at caesarean section in the very severely obese: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0216157
    DOI: 10.1371/journal.pone.0216157
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    References listed on IDEAS

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    1. Chuan Zhang & Lingli Zhang & Xinghui Liu & Li Zhang & Zhiyou Zeng & Lin Li & Guanjian Liu & Hong Jiang, 2015. "Timing of Antibiotic Prophylaxis in Elective Caesarean Delivery: A Multi-Center Randomized Controlled Trial and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-15, July.
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