Panniculectomy at the Time of Cesarean Section and Postoperative Wound Complications in Morbidly Obese Women.

OBJECTIVE

To determine whether a modified abdominal panniculectomy at the time of cesarean delivery decreases wound complications in morbidly obese women.

STUDY DESIGN

This is a retrospective cohort study of 59 morbidly obese patients who delivered via cesarean section at a single center between 2003 and 2009. A total of 30 morbidly obese patients who underwent modified panniculectomy at the time of cesarean section were compared to a control group of 29 morbidly obese women who underwent cesarean section alone.

RESULTS

Of the 30 women who underwent modified panniculectomy at the time of cesarean, 3% (n = 1) developed operative site infection that required readmission. In the control group, 24% (n = 7) developed operative site infection (p = 0.026), and 10% (n = 3) were readmitted (p = 0.35). There was no difference in the postpartum length of hospital stay, intraoperative blood loss, operative time and infant delivery time between the two groups.

CONCLUSION

In our cohort, morbidly obese women who underwent panniculectomy at the time of cesarean section had lower incidence of wound complications without significant increase in operative time, hospital length of stay, and infant delivery time. Modified panniculectomy at the time of cesarean may be a useful adjunct in an effort to decrease postoperative infectious morbidity in obese patients. However, the effects of the procedure on long-term healing,future obstetric outcomes, and other medical conditions warrant further evaluation.