patients will receive sterile wound dressing of gauze and tape for 4 days.

patients will receive placement of a sterile dressing of gauze and occlusive adhesive over the closed incision. The dressing's tubing will then be attached to a compact, portable negative-pressure therapy unit (Yuwell 7E-A portable suction unit) that will deliver -80 mm Hg of continuous pressure to the dressing and will remove exudates into a disposable canister for 4 days.

Wound Dehiscence

A portable suction unit that will deliver 125 mm Hg of continuous pressure to the dressing and will remove exudates into a disposable canister for 4 days.

External negative pressure dressing system (Yuwell 7E-A portable suction unit)

External Negative Pressure Dressing System vs. Traditional Wound Dressing for Cesarean Section Incision in Obese Women.

External Negative Pressure Dressing System (ENPDS) vs. Traditional Wound Dressing for Cesarean Section Incision in Obese Women.

separation of the incision line prior to complete healing resulting in an open wound.

post-operative pain assessed by Wong-Baker Faces pain rating scale,from 0=no pain to 10=maximal pain

if the patient encountered surgical site infection requiring re admission to the hospital

if the surgical site infection required additional post operative antibiotics

if any skin blistering occurs under the occlusive adhesive layer

if attachment to a negative pressure pump affects patients mobility

patient's age ,ethnicity,gravidity,parity,gestational age ,previous cesarean section, previous surgeries,weight, height,BMI,pre/post operative haemoglobin,degree of post operative pain,incidence and type of surgical site infection,length of hospital stay, need for re-admission,need for additional antibiotics

Dalia Magdy Mokhtar

resident of obstetrics and gynecology

Ain Shams Maternity Hospital

Basic information included age, ethnicity, weight, height, body mass index (BMI).
Full obstetric, medical and surgical history. Informed written consent will be obtained Patients will receive standard preoperative antibiotic prophylaxis Wound dressing will be applied in a sterile fashion after primary closure of the Pfannenstiel incision closure by interrupted PROLENE Polypropylene Sutures The intervention group: placement of a sterile multilayer dressing (wicking fabric, reticulated foam, and occlusive adhesive). The dressing's tubing will then be attached to a (Yuwell 7E-A portable suction unit) that will deliver 125 mm Hg of continuous pressure to the dressing for 4 days.
The comparison group: traditional sterile wound dressing of gauze and tape for 4 days.
Post-operative data including: type of dressing used, postoperative hemoglobin, degree of pain, length of hospital stay, readmission for surgical site infection and the type of the surgical site infection.

Stage 1 will determine the prevalence of chronic oedema among patients attending weight management services at the Royal Derby Hospital and how it impacts on every day life.

Stage 2 will determine whether bariatric surgery improves the oedema.

Chronic Oedema

Obesity

This observational study follows patients after routine bariatric surgery.

Stage 2 - Bariatric Surgery

Royal Derby Hospital

Prevalence of Chronic Oedema in Obese Patients

Prevalence and Impact of Chronic Oedema in a Population of Patients Prior to and Following Bariatric Surgery

This will be achieved using: a clinical assessment to identify the presence or absence of chronic oedema.

This will be achieved using a clinical assessment to identify the degree of swelling in the affected areas.

This will be achieved using a range of quality of life questionnaires to identify the impact that the swelling has on the participants.

This will be achieved by serial clinical assessment measures over a 12-month follow up after surgery.

The quality of life of participants with and without chronic oedema will be compared, using the scores from the quality of life questionnaires.

The bioimpedance data (measures total fluid within the legs) will be used to determine if the technique can define chronic oedema in this setting.

The tissue dielectric constant data (measures fluid levels at different points) will be used to determine if the technique can define chronic oedema in this setting.

The questionnaires will be used to collect data about the presence/severity of swelling of the patients. These will be important as they will help to determine the impact of chronic oedema on everyday life.

The bioimpedance technique will be used to measure changes in the oedema from the baseline (pre-operative) measurement. The use of this technique will be validated by comparing the results with clinical assessment and limb volume measurements.

The tissue dielectric constant technique will be used to measure changes in the oedema from the baseline (pre-operative) measurement. The use of this technique will be validated by comparing the results with clinical assessment and limb volume measurements.

The clinical assessments [presence/severity of swelling and wounds (if present)] of the patients from their preoperative to their 12-month post-operative appointment will be compared in order to determine the impact of weight loss on chronic oedema. The effect sizes of these changes will be used to inform future study design and sample size calculation.

The quality of life scores of the patients from their preoperative to their 12-month post-operative appointment will be compared in order to determine the impact of weight loss on chronic oedema. The effect sizes of these changes will be used to inform future study design and sample size calculation.

Recruitment data (the percentage of eligible patients who consent to take part in the study, and the number withdrawing or not completing the study follow-up) will be used to inform sample size calculation for the future study.

Individual participant data will be sent out after the study has ended to participants who request them.

cellulitis/fetma

External Negative Pressure Dressing System vs. Traditional Wound Dressing for Cesarean Section Incision in Obese Women.

Prevalence of Chronic Oedema in Obese Patients

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