Maternal Morbidity associated with Skin Incision Type at Cesarean Delivery in Obese Patients: A Systematic Review

OBJECTIVE: To describe the relationship between cesarean skin incision type and
postoperative wound complications in obese pregnant
patients.

MATERIALS AND
METHODS: MEDLINE
(PubMed, OVID), Embase, Scopus, Web of Science Core Collection, Cochrane
Library, and ClinicalTrials.gov databases were used for publication search.
Selection criteria consisted of articles studying
pregnant patients with BMI ≥30 kg/m2 undergoing cesarean delivery
and assessing the effect of skin incision type on post-operative maternal
outcomes.

RESULTS: Ten publications
met criteria for a systematic review of a total of 2946 patients. The
transverse skin incision was associated with a
lower rate of wound complication compared
with the vertical skin incision. The pooled risk-ratio for wound complications was 0.47 (95% CI
0.37-0.58, p<0.00001).

CONCLUSION: Transverse skin incision may be preferable to
vertical skin incision at cesarean delivery in pregnant patients with obesity as it may be
associated with a lower rate of wound complications.