Prophylactic Negative Pressure Wound Therapy with the Medela Invia Motion at Cesarean Delivery: a Pilot Study

Author(s): Ryan N. Kuuseg, Methodius G. Tuuli

Objective:

To assess patient centered outcomes associated with use of the Medela INVIA Motion prophylactic negative pressure wound therapy (NPWT) system at cesarean delivery.

Methods:

This was a single arm trial including patients undergoing scheduled or unscheduled cesarean delivery at or greater than 23 weeks’ gestation. Patients unwilling to provide consent, unavailable for follow up or with a contraindication use of prophylactic NPWT were excluded. Consented patients had the Medela INVIA Motion prophylactic NPWT system placed and secured after skin closure. The device was removed at discharge (typically postoperative day 3-4). Patient reported outcomes were pain scores on a scale of 0 (no pain) to 10 (worst pain) and patient satisfaction scores on a scale of 0 (completely dissatisfied) to 10 (completely satisfied) at discharge and postoperative day 30. Other outcomes were a composite of wound complication including wound infection, would separation, seroma, antibiotics prescribed for presumed surgical site infection within 30 days, and occurrence of adverse skin reactions potentially related use of prophylactic NPWT.

Results:

A total of 20 patients undergoing cesarean delivery were included. The average body mass index at delivery was 37 kg/m2. All patients had routine infection prevention measures. Nearly all patients had a Pfannenstiel incision skin incision. Pain scores were generally low at the time of discharge (median score 2.5 [IQR 1, 5]) and near 0 by postoperative day 30 (median 0 [IQR 0, 1]). Patients were very satisfied with their experience using the Medela INVIA Motion prophylactic NPWT at discharge (median score 10 [IQR 8.5, 10]) and postoperative day 30 (median score 10 [IQR 10, 10]). There was no wound complication or adverse skin reaction.

Conclusion:

Use of the Medela INVIA Motion prophylactic NPWT after cesarean delivery was associated with low pain, high satisfaction and no increase in adverse skin reactions. (ClinicalTrials.gov#NCT04365452)