Adding negative pRESSure to improve healING (the DRESSING trial)

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Obesity is a growing global public health problem in developed nations. It is estimated that half of all Australian women of childbearing age are overweight or obese. Obese pregnant women are more likely to deliver their babies by caesarean section and are also more likely to have complications such as surgical site infections after caesarean section than non-obese women. Wounds that fail to heal may cause considerable distress to patients and negatively affect the physical, social, emotional and economic aspects of their life. Wound complications also add to the cost of health care. Negative Pressure Wound Therapy has been used to aid healing since it was first developed in the late 1990s. The treatment is based on a closed sealed system that produces negative pressure to the wound surface. The wound is covered and sealed with an occlusive dressing and suction tube which is connected to a vacuum pump which provides intermittent or continuous suction. Negative Pressure Wound Therapy is being used more frequently as a way to prevent wound complications especially surgical site infection, but it has not been well tested yet. This study will test the effectiveness of two different methods to dress surgical wounds following caesarean section. These include Negative Pressure Wound Therapy compared to current care (standard care). We are doing this research study to find out the best practice for preventing Surgical Site Infections in obese women. To do this we need to study women with a body mass index (BMI) greater than or equal to 30 for one month following their surgery, and closely monitor their surgical wound.