Dr Mendinaro Imcha
Clinical Lead for Obstetrics & Gynaecology, UL Hospitals Group
Kate Backshell
Vice President, Advanced Wound Management UK, Ireland and Nordics (UKINOR) Smith+Nephew
Wound care technology is helping reduce the risk of surgical site infections in caesarean section (or C-section) procedures in at-risk patients, leaving mothers able to focus on their newborns.
Surgical site infections after mothers give birth by C-section can cause a range of health concerns. It can lead to emotional stress and wound complications requiring further medical intervention. It can also interrupt the natural bonding process between mother and baby.
Proactive healing strategies
Dr Mendinaro Imcha, consultant obstetrician and gynaecologist at University Hospital Limerick in Ireland, says surgical site infections (SSIs) may interfere with breastfeeding or the patient’s wellbeing. “Infections slow down the healing process, hindering the mother’s ability to care for her newborn and resume daily activities.”
Quick healing of the incision requires a multifaceted approach, involving both medical professionals and patients. Dr Imcha says that includes pre-operative screening for high-risk factors and regular checks for infection after the C-section. Proactive strategies for avoiding SSIs have a ripple effect that benefits individual patients, healthcare providers and the wider public health system,” she adds.
Therapy to help promote wound healing
Single-use negative pressure wound therapy (sNPWT), such as Smith+Nephew’s PICOTM sNPWT solution, can aid recovery,1 particularly in obese women undergoing C-section.2 Dr Imcha explains the proposed mechanism of NPWT. “The negative pressure facilitates cell proliferation and the formation of granulation tissue, which is essential for wound healing and improves blood circulation. The sealed environment, created by the dressing, minimises external contamination risks, effectively shielding the wound from bacteria.”3,4
Benefits of mother-baby bonding
Dr Imcha says her experience of NPWT in the clinical setting has been positive. Patients report comfort and less pain compared to care with standard dressing.5,6 Highlighting mother-baby bonding, she adds: “It is not merely a warm and comforting experience but a critical period that can significantly influence the psychological, emotional and physical trajectory of the child and the mother.” Immediate skin-to-skin contact encourages breastfeeding, providing the newborn with essential nutrients and antibodies.
When you have an SSI, you can be in great
Kate Backshell
pain and discomfort, and that can affect
your physical ability to pick up the baby.
Availability of wound care tech
In the UK, around one in four pregnant women every year give birth via C-section7 (around 150,000), with data suggesting 10% are at risk of developing a SSI.8 Kate Backshell, Vice President, Advanced Wound Management UK, Ireland and Nordics (UKINOR) Smith+Nephew, shares her experience of the PICOTM dressing after her children — now aged 4 and 6 — were delivered by C-section. She says women should know that effective wound care technologies are available. “Dressings are just one part of the pathway for reducing the risk of surgical site complications, but choosing an appropriate dressing can make a significant difference.”
People at risk of infection
The active therapy, rather than a passive absorbent dressing, is NICE-recommended for patients who are at risk of developing an SSI9 and is available on the NHS. Backshell says the solution can reduce infection risk by over 50% by creating gentle pressure across the incision line.10 It can be applied immediately after the C-section and has particular benefits for women identified at the pre-op stage as at risk of SSI. This includes people who have had a previous C-section, have diabetes or a body mass index of 30+.8,10
Secure healing
Backshell says the first weeks with a new baby are all-consuming, with mothers needing time and space to bond with their baby. “When you have an SSI, you can be in great pain and discomfort, and that can affect your physical ability to pick up the baby.”
With the birth of both of her children, she was grateful to have access to the PICOTM system, which enabled her to focus on being a new mum. “With the PICOTM dressing, I had the confidence that the incision would just heal,” she says. “The way the dressing bolsters the incision together makes it feel very secure.”
The clinician testimonial in this article represents the individuals’ own opinions, findings and/or experiences. Individual results will vary. TM Trademark of Smith+Nephew. 40793.
[1] Birke-Sorensen H, Malmsjo M, Rome P, et al. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)-steps towards an international consensus. J Plast Reconstr Aesthet Surg. 2011;64 Suppl:S1-16.
[2] Hyldig N, Vinter CA, Kruse M, et al. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2018;0(0).
[3] Brownhill VR, Huddleston E, Bell A, et al. Pre-Clinical Assessment of Single-Use Negative Pressure Wound Therapy During In Vivo Porcine Wound Healing. Adv Wound Care (New Rochelle). 2020;0(0):1 – 12.
[4] Smith+Nephew 2020.Bacterial barrier testing of the PICO dressing. Internal Report. 2001002.
[5] Gilchrist B, Robinson M, Jaimes H. Performance, safety, and efficacy of a single use negative pressure wound therapy system for surgically closed incision sites and skin grafts: A prospective multi-centre follow-up study. Paper presented at: SAWC; 2020; Virtual.
[6] Hurd T, Trueman P, Rossington A. Use of a Portable, Single-use Negative Pressure Wound Therapy Device in Home Care Patients with Low to Moderately Exuding Wounds: A Case Series. Ostomy Wound Manage. 2014;60(3):30-36.
[7] NHS Choices. Available at: https://www.nhs.uk/conditions/caesarean-section/ (accessed September, 2023)
[8] Wloch C, Wilson J, Lamagni T, Harrington P, Charlett A, Sheridan E. Risk factors for surgical site infection following caesarean section in England: results from a multicentre cohort study. BJOG: An International Journal of Obstetrics & Gynaecology.2012 Oct;119(11):1324- 33.
[9] NICE, 2019. PICO negative pressure wound dressings for closed surgical incisions [online] accessible from: https://www.nice.org.uk/guidance/mtg43. [Last accessed: Sept 2023]
[10] Hyldig N, Vinter CA, Kruse M, Mogensen O, Bille C, Sorensen JA, et al. , Lamont RF, Wu C, Heidemann LN, Ibsen MH, Laursen JB. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2019 Apr;126(5):628-3
