Timing of Cesarean Wound Dressing Removal on Wound Healing in Women With BMI ≥ 30 kg/m²

NCT07846930 — Not yet recruiting, 726 participants, Assiut University

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Effect of Cesarean Wound Dressing Removal Timing on Wound Healing in Women With BMI ≥ 30 kg/m²

RegistryNCT07846930
StatusNot yet recruiting
Study typeObservational
Enrollment726 (Estimated)
SponsorAssiut University (Other)
ConditionsCesarean Section, Surgical Wound Infection, Wound Healing, Obesity, Surgical Wound Dehiscence
Datesstart 2026-10-01 (estimated), primary completion 2027-10-01 (estimated), completion 2027-11-01 (estimated), first posted 2026-09-29, last updated 2026-09-29

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-Summary

Cesarean delivery is one of the most common surgical procedures in obstetric care. Women with obesity (body mass index \[BMI\] of 30 kg/m² or higher) are at increased risk for postoperative wound complications, including surgical site infections, fluid collections (seroma/hematoma), and wound separation. Postoperative wound dressings protect the surgical incision, but the optimal timing for dressing removal remains uncertain, particularly for high-risk patients.

The purpose of this prospective cohort study is to compare wound healing and the occurrence of surgical site infections between two standard dressing removal schedules in women with a BMI ≥ 30 kg/m² undergoing cesarean delivery.

Participants are observed in one of two groups according to standard hospital practice:

* Group 1: The sterile wound dressing is removed at approximately 48 hours after surgery.
* Group 2: The sterile wound dressing is removed at approximately 5 days after surgery.

Following dressing removal, incisions are assessed for signs of infection, drainage, swelling, and healing progress. The study aims to provide evidence on whether earlier dressing removal at 48 hours is safe and effective compared to delayed removal at 5 days in women with obesity.

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+Arms and interventions

ArmTypeInterventionsDescription
48-Hour Dressing RemovalWomen with BMI ≥ 30 kg/m² undergoing cesarean delivery with a Pfannenstiel skin incision whose standardized sterile wound dressing is removed at approximately 48 hours after surgery, followed by clinical wound inspection under aseptic conditions and routine postoperative care.
5-Day Dressing RemovalWomen with BMI ≥ 30 kg/m² undergoing cesarean delivery with a Pfannenstiel skin incision whose standardized sterile wound dressing is removed at approximately 5 days after surgery, followed by clinical wound inspection under aseptic conditions and routine postoperative care.

+Outcome measures

Primary outcomes

  • Number of Participants With Surgical Site Infection (SSI) [Up to 48 hours after dressing removal]: Number of participants diagnosed with a surgical site infection (SSI) at the Pfannenstiel incision site. Assessment is performed using a standardized clinical wound-assessment form evaluating the presence of purulent discharge, localized erythema, heat, edema, or wound separation.

+Eligibility

Sex: Female, ages: 18 Years to 35 Years

Inclusion Criteria:

* Women aged 18 to 35 years
* Body mass index (BMI) ≥ 30 kg/m² measured before cesarean delivery or at admission
* Undergoing cesarean delivery with a Pfannenstiel skin incision and primary skin closure

Exclusion Criteria:

* Pre-existing infection or inflammation at the planned incision site
* Active systemic infection or fever prior to surgery
* Clinical or subclinical chorioamnionitis
* Major intraoperative contamination of the surgical field
* Significant preoperative bleeding or anemia
* Known bleeding or coagulation disorders that may significantly affect wound healing
* Major postoperative complications requiring additional abdominal surgery
* Inability or unwillingness to attend scheduled follow-up visits