Timing of Cesarean Wound Dressing Removal on Wound Healing in Women With BMI ≥ 30 kg/m²

September 23, 2026 updated by: Mohamed Tawfik Abdelmalek Gomaa, Assiut University

Effect of Cesarean Wound Dressing Removal Timing on Wound Healing in Women With BMI ≥ 30 kg/m²

Cesarean delivery is one of the most common surgical procedures in obstetric care. Women with obesity (body mass index [BMI] of 30 kg/m² or higher) are at increased risk for postoperative wound complications, including surgical site infections, fluid collections (seroma/hematoma), and wound separation. Postoperative wound dressings protect the surgical incision, but the optimal timing for dressing removal remains uncertain, particularly for high-risk patients.

The purpose of this prospective cohort study is to compare wound healing and the occurrence of surgical site infections between two standard dressing removal schedules in women with a BMI ≥ 30 kg/m² undergoing cesarean delivery.

Participants are observed in one of two groups according to standard hospital practice:

  • Group 1: The sterile wound dressing is removed at approximately 48 hours after surgery.
  • Group 2: The sterile wound dressing is removed at approximately 5 days after surgery.

Following dressing removal, incisions are assessed for signs of infection, drainage, swelling, and healing progress. The study aims to provide evidence on whether earlier dressing removal at 48 hours is safe and effective compared to delayed removal at 5 days in women with obesity.

Study Overview

Study Type

Observational

Enrollment (Estimated)

726

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 35 years (Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

Pregnant women aged 18 to 35 years with a body mass index (BMI) ≥ 30 kg/m² undergoing cesarean delivery via a Pfannenstiel skin incision at the Department of Obstetrics and Gynecology, Assiut University Hospitals, and Malawi Specialized Hospital.

Description

Inclusion Criteria:

  • Women aged 18 to 35 years
  • Body mass index (BMI) ≥ 30 kg/m² measured before cesarean delivery or at admission
  • Undergoing cesarean delivery with a Pfannenstiel skin incision and primary skin closure

Exclusion Criteria:

  • Pre-existing infection or inflammation at the planned incision site
  • Active systemic infection or fever prior to surgery
  • Clinical or subclinical chorioamnionitis
  • Major intraoperative contamination of the surgical field
  • Significant preoperative bleeding or anemia
  • Known bleeding or coagulation disorders that may significantly affect wound healing
  • Major postoperative complications requiring additional abdominal surgery
  • Inability or unwillingness to attend scheduled follow-up visits

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: PROSPECTIVE

Cohorts and Interventions

Group / Cohort
48-Hour Dressing Removal

Women with BMI ≥ 30 kg/m² undergoing cesarean delivery with a Pfannenstiel skin incision whose standardized sterile wound dressing is removed at approximately 48 hours after surgery, followed by clinical wound inspection under aseptic conditions and routine postoperative care.

5-Day Dressing Removal

Women with BMI ≥ 30 kg/m² undergoing cesarean delivery with a Pfannenstiel skin incision whose standardized sterile wound dressing is removed at approximately 5 days after surgery, followed by clinical wound inspection under aseptic conditions and routine postoperative care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Surgical Site Infection (SSI)
Time Frame: Up to 48 hours after dressing removal

Number of participants diagnosed with a surgical site infection (SSI) at the Pfannenstiel incision site. Assessment is performed using a standardized clinical wound-assessment form evaluating the presence of purulent discharge, localized erythema, heat, edema, or wound separation.

Up to 48 hours after dressing removal

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

November 1, 2027

Study Registration Dates

First Submitted

September 23, 2026

First Submitted That Met QC Criteria

September 23, 2026

First Posted (Actual)

September 29, 2026

Study Record Updates

Last Update Posted (Actual)

September 29, 2026

Last Update Submitted That Met QC Criteria

September 23, 2026

Last Verified

September 1, 2026

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe