Journal Mobile Options
Table of Contents
Vol. 53, No. 2, 2002
Issue release date: April 2002
Gynecol Obstet Invest 2002;53:75–78

Value of Subcutaneous Drainage System in Obese Females Undergoing Cesarean Section Using Pfannenstiel Incision

Al-Inany H. · Youssef G. · Abd ElMaguid A. · Abdel Hamid M. · Naguib A.
Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Objective: To determine whether closed subcutaneous drainage systems were efficacious in reducing the rate of wound breakdown of Pfannenstiel incision after cesarean section (CS) in obese females. Design: Prospective controlled clinical trial. Participants: 118 obese pregnant females with a body mass index >32 undergoing CS were divided into two groups: group I (n = 78) with closed subcutaneous drainage system and group II (n = 40) without drainage system. Incision closure technique was standardized. Prophylactic antibiotics were given routinely to both groups. Outcome Measures: Primary outcomes were the incidence of wound breakdown in both groups together with rate of hematoma formation and occurrence of fever. Secondary outcomes were amount of fluid drained, need for redressing. Results: Wound breakdown occurred in 9 cases in group I (11.5%), while it happened in 5 cases in group II (12.5%) (p > 0.05). Relative risk was 0.92 (95% CI 0.26–3.75). Hematoma formation was observed in only 1 case in the nondrainage group (group II). Fever was observed in 18 cases in group I (23.1%) in the first 24 h postoperative while in group II, 13 cases developed fever (32.5%) (p > 0.05). The need for redressing within the first 24 h was only in 2.5% of cases in group I while it was 17.9% in group II (p < 0.05). Conclusion: We found no significant benefit in using a subcutaneous drain as a prophylactic measure against wound breakdown in obese pregnant females undergoing CS as long as they received a prophylactic antibiotic.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Soper DE, Bump RC, Hurt WG: Wound infection after abdominal hysterectomy: Effect of the depth of subcutaneous tissue. Am J Obstet Gynecol 1995;173:465–471.
  2. National Academy of Sciences, National Research Council: Postoperative wound infections: The influence of ultraviolet irradiation of the operating room and various other factors. Ann Surg 1964;160(suppl):1–132.
  3. Gallup DC, Gallup DG, Nolan TE, Smith RP, Messing MF, Kline KL: Use of a subcutaneous closed drainage system and antibiotics in obese gynecologic patients. Am J Obstet Gynecol 1996;175:358–362.
  4. Seidell JC, Flegal KM: Assessing obesity: Classification and epidemiology. Br Med Bull 1997;53:238–252.
  5. Naumann RW, Hauth JC, Owen J, Hodgkins PM, Lincoln T: Subcutaneous tissue approximation in relation to wound disruption after cesarean delivery in obese women. Obstet Gynecol 1995;85:412–416.
  6. Cetin A, Cetin M: Superficial wound disruption after cesarean delivery: Effect of the depth and closure of subcutaneous tissue. Int J Gynaecol Obstet 1997;57:17–21.
  7. Vermillion ST, Lamoutte C, Soper DE, Verdeja A: Wound infection after cesarean: Effect of subcutaneous tissue thickness. Obstet Gynecol 2000;95:923–926.

    External Resources

  8. Davidson AIG, Clark C, Smith G: Postoperative wound infection: A computer analysis. Br J Surg 1971;58:333–337.

    External Resources

  9. Cruse PJE, Foord R: A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973;107:206–210.
  10. Garrow JS, Hastings EJ, Cox AG, et al: Obesity and postoperative complications of abdominal operation. BMJ 1988;297:181.
  11. Pitkin RM: Abdominal hysterectomy in obese women. Surg Gynecol Obstet 1976;142:532–536.

    External Resources

  12. McIlrath DC, van Heerden JA, Edis JA, Dozois RR: Closure of abdominal incisions with subcutaneous catheters. Surgery 1976;80:411–416.

    External Resources

  13. Higson RH, Kettlewell MGW: Parietal wound drainage in abdominal surgery. Br J Surg 1978;65:326–329.

    External Resources

  14. Allaire AD, Fisch J, McMahon MJ: Subcutaneous drain vs. suture in obese women undergoing delivery. A prospective randomized trial. J Reprod Med 2000;45:327–331.
  15. Kore S, Vyavaharkar M, Akolekar R, Toke A, Ambiye V: Comparison of closure of subcutaneous tissue versus non-closure in relation to wound disruption after abdominal hysterectomy in obese patients. J Postgrad Med 2000;46:26–28.

    External Resources

Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00