ADding negative pRESSure to improve healING (the DRESSING trial): a RCT protocol

BMJ Open. 2016 Feb 1;6(2):e010287. doi: 10.1136/bmjopen-2015-010287.

Abstract

Introduction: Obese women are more likely to develop a surgical site infection (SSI) following caesarean section (CS) than non-obese women. Negative pressure wound therapy (NPWT) is increasingly being used to reduce SSI with limited evidence for its effectiveness.

Objectives: To determine the clinical and cost-effectiveness of using NPWT in obese women having elective and semiurgent CS.

Methods and analysis: A multisite, superiority parallel pragmatic randomised controlled trial with an economic evaluation. Women with a body mass index (BMI) of ≥ 30, booked for elective and semiurgent CS at 4 Australian acute care hospitals will be targeted. A total of 2090 women will be enrolled. A centralised randomisation service will be used with participants block randomised to either NPWT or standard surgical dressings in a 1:1 ratio, stratified by hospital. The primary outcome is SSI; secondary outcomes include type of SSI, length of stay, readmission, wound complications and health-related quality of life. Economic outcomes include direct healthcare costs and cost-effectiveness, which will be evaluated using incremental cost per quality-adjusted life year gained. Data will be collected at baseline, and participants followed up on the second postoperative day and weekly from the day of surgery for 4 weeks. Outcome assessors will be masked to allocation. The primary statistical analysis will be based on intention-to-treat.

Ethics and dissemination: Ethics approval has been obtained from the ethics committees of the participating hospitals and universities. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations.

Trial registration number: ACTRN12615000286549; Pre-results.

Keywords: WOUND MANAGEMENT.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Cesarean Section*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Negative-Pressure Wound Therapy / economics
  • Negative-Pressure Wound Therapy / methods*
  • Obesity / complications*
  • Pregnancy
  • Research Design*
  • Surgical Wound Infection / economics
  • Surgical Wound Infection / prevention & control*
  • Treatment Outcome
  • Wound Healing*

Associated data

  • ANZCTR/ACTRN12615000286549