Preventing post-C-section wound complications: How choosing the right single-use negative pressure wound therapy affects outcomes

In the U.S., the rate of Cesarean sections jumped 55% in the 25 years ending in 2021, and now, three in every 10 births occurs by C-section, according to the Centers for Disease Control (CDC). With this increase comes risks, however, including the potential for complications affecting the surgical site. In fact, 44.6% of C-section patients are considered high risk^LS1 , with the chances of surgical site complications especially high among certain patient groups, including people with diabetes or hypertension^LS2 .

With C-sections on the rise, the need for proper post-C-section wound care is more important than ever. A recent survey conducted by Smith+Nephew ^LS3 highlights the burdens new mothers with C-section complications face. The data reveals that C-section complications negatively impact the postpartum experience, with many respondents reporting experiences such as depression, pain and struggles bonding with their newborns.

One option for helping reduce the risk of C-section wound complications is to replace standard dressings with single-use negative pressure wound therapy (sNPWT). These advanced devices are designed to reduce swelling and remove excess fluid from the wound site.

Obstetricians can choose sNPWT therapies at pressure levels of −80 mm Hg or −125 mm Hg — but making the right selection is complicated by a lack of head-to-head research assessing the two options. A recent study comparing Smith+Nephew’s PICO^◊ sNPWT -80mmHg device to a −125 mm Hg device highlights several advantages the lower-pressure device offers in C-section recovery.

Improving the post-partum experience

Removing fluid from the C-section site using negative pressure is a primary method for preventing complications such as infection, swelling and dehiscence, which is the reopening of the wound^LS4 . Single-use negative pressure wound therapy is available in two different forms with distinct modes of action. The −125 mm Hg device draws fluid from the surgical wound through a foam filler and into a canister. The PICO sNPWT −80 mm Hg device facilitates the evaporation of fluid through a four-layer dressing. ^LS5

For a 2025 study comparing the two negative-pressure options, researchers collected real-world data from C-sections in 5,332 patients treated with PICO sNPWT and 5,332 who received the −125 mm Hg device between 2017 and 2022. The endpoints they analyzed included deep, superficial and overall surgical site infections. They also analyzed rates of dehiscence, seroma and hematoma, as well as length of stay and costs. The study was led by researchers from Henry Ford Medical Center in Detroit, Smith+Nephew, and Valley Health System in Ridgewood, NJ.

The researchers determined that 30 days post-surgery, the incidence of overall and superficial surgical site infections were significantly lower with PICO sNPWT than they were with the −125 mm Hg device. The incidence of dehiscence was also lower, as was that of seroma, a buildup of fluid at the surgical site that can cause pain.

“Finding the right balance of pressure to put on an incision can be challenging. Based on this study, there are benefits to using a dressing with a lower pressure,” says study co-author Dr. Annmarie Vilkins, an OBGYN at Henry Ford. She adds that the mean length of stay for patients using the PICO sNPWT device was lower than it was for the higher-pressure dressing (although this difference was not statistically significant).

Reducing the length of hospital stays post-C-section is just one example of how improving wound care with sNPWT could enhance the recovery experience for mothers requiring the procedure. A survey of new moms conducted by Smith+Nephew ^LS6 revealed that complications after undergoing a C-section can impose several burdens as they navigate their postpartum recovery. For example, mothers with C-section complications are five times more likely to say their recovery was “traumatic” and more than five times more likely than mothers without complications to be unable to breastfeed. Two in three mothers said their C-section recovery interfered with their ability to bond with their baby.

“We are seeing an increased rate of postpartum depression even in uncomplicated pregnancies. When a patient has a wound, they have to deal with wound care, a new baby and maybe even other children in the home,” says Dr. Tia Welsh, an OBGYN and co-author of the sNPWT study. “We’re trying to take as much of the burden off moms so they can go home healthy. When we decrease the incidence of infections, we’re increasing the mental stability of our patients.”

Lowering healthcare costs with sNPWT

The improvement in clinical outcomes from the use of sNPWT in women undergoing C-section offer the potential to help lower overall healthcare costs.

One study of more than 720,000 surgeries that required hospitalizations concluded that surgical site infections extend the length of hospital stays by nearly 10 days, leading to hospital costs of more than $900 million per year. Another study focusing on C-sections found that surgical site complications cost nearly $3,000 per patient.

While additional research is needed to elucidate the impact of PICO sNPWT’s clinical advantages on costs, Smith+Nephew’s study’s findings indicate that −80 mm Hg sNPWT does offer cost advantages over the higher-pressure option. Taking into account unadjusted costs at 90 days following C-section, the study determined that PICO sNPWT could translate to potential estimated cost savings of $728,220 per 1,000 patients.

While saving costs is important, Dr. Vilkins says, improving post-partum recovery is what’s top- of-mind for clinicians who see the impact of C-sections on patients every day. “On the list of things that have to get done after having a baby, caring for a wound is at the very bottom,” Dr. Vilkins says. Helping reduce the risk of complications with sNPWT, she says, is “like sending patients home with a personal assistant for their wound — it can help to alleviate some anxiety.”