American journal of obstetrics & gynecology MFM · 2025
Early wound dressing (soft gauze/tape dressing) removal after cesarean delivery: a meta-analysis of randomized trials.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Cenac Leshae A, Guerra Serena, Huckaby Alicia, Saccone Gabriele, Berghella Vincenzo
Аннотация
OBJECTIVE: To assess whether removing the wound dressing within 24 hours after a cesarean delivery leads to any negative effects on wound healing and to recommend the best time for dressing removal.
DATA SOURCES: Science Direct, PubMed, Cochrane Library, and Scopus as the electronic databases from their inception until December 2024.
CRITERIA FOR STUDY ELIGIBILITY: Randomized controlled trials (RCTs) were incorporated in the databases, irrespective of their publication language, sample size, publication date, use of blinding, or study setting/location.
STUDY APPRAISAL AND SYNTHESIS METHODS: A systematic review of RCTs was conducted to compare wound outcomes in cesarean delivery patients with early dressing removal vs standard care. Utilizing an intent-to-treat approach, the analysis evaluated wound complication rates through both objective wound scores and subjective patient-reported complaints. The primary outcome of the study was postoperative wound complications, defined as any of the following: infection, disruption (skin dehiscence or deeper), or seroma/hematoma. The summary measures were reported as odds ratio (OR) or as mean difference with 95% of confidence interval (CI), using the random effects model of DerSimonian and Laird.
RESULTS: Four trials, including 2130 participants, were included in the meta-analysis. Most of them defined early dressing removal as 24 hours after cesarean, and late removal as 48 hours after cesarean. All trials used soft gauze/tape dressing. Pooled data showed that early removal did not increase the incidence of wound complications (17.9% vs 19.4%; OR 0.90, 95% CI 0.72-1.14), and was associated with higher maternal satisfaction.
CONCLUSION: Early dressing removal (≤24 hours) after cesarean delivery appears to be safe and preferable compared to later removal, since it is associated with higher maternal satisfaction. El resumen está disponible en Español al final del artículo.
DATA SOURCES: Science Direct, PubMed, Cochrane Library, and Scopus as the electronic databases from their inception until December 2024.
CRITERIA FOR STUDY ELIGIBILITY: Randomized controlled trials (RCTs) were incorporated in the databases, irrespective of their publication language, sample size, publication date, use of blinding, or study setting/location.
STUDY APPRAISAL AND SYNTHESIS METHODS: A systematic review of RCTs was conducted to compare wound outcomes in cesarean delivery patients with early dressing removal vs standard care. Utilizing an intent-to-treat approach, the analysis evaluated wound complication rates through both objective wound scores and subjective patient-reported complaints. The primary outcome of the study was postoperative wound complications, defined as any of the following: infection, disruption (skin dehiscence or deeper), or seroma/hematoma. The summary measures were reported as odds ratio (OR) or as mean difference with 95% of confidence interval (CI), using the random effects model of DerSimonian and Laird.
RESULTS: Four trials, including 2130 participants, were included in the meta-analysis. Most of them defined early dressing removal as 24 hours after cesarean, and late removal as 48 hours after cesarean. All trials used soft gauze/tape dressing. Pooled data showed that early removal did not increase the incidence of wound complications (17.9% vs 19.4%; OR 0.90, 95% CI 0.72-1.14), and was associated with higher maternal satisfaction.
CONCLUSION: Early dressing removal (≤24 hours) after cesarean delivery appears to be safe and preferable compared to later removal, since it is associated with higher maternal satisfaction. El resumen está disponible en Español al final del artículo.