PICO Negative Pressure Wound Therapy in Obese Women Undergoing Elective Cesarean Delivery.

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study; willing and able to return for all scheduled and required study visits * Female, aged 18 - 55 years * BMI ≥ 35 kg/m2 in the 42 days prior to surgery * In good general health as evidenced by medical history with a 24 - 41 weeks gestational age pregnancy scheduled for cesarean delivery for any routine indication (repeat procedure, breech presentation, abnormal placentation, uterine anomaly, maternal medical condition, or elective) * Surgical skin site preparation with chlorhexidine gluconate solution (ChloraPrep©) * Received preoperative surgical prophylaxis antibiotics as per protocol * Surgical incision that can be covered completely by the NPWT skin system * Pre-operatively assessed to undergo a procedure with a CDC Wound Classification of: a. Class I (Clean): An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered * OR - b. Class II (Clean Contaminated): An operative wound in which the respiratory, alimentary, genital, or uninfected urinary tract are entered under controlled conditions and without unusual contamination * Wound hemostasis has been achieved Exclusion Criteria: * Cesarean delivery before fetal viability (24 0/7 weeks gestational age) * Unplanned Cesarean delivery * Intrauterine fetal demise * Known allergic reactions to components of the PICO NPWT system * Systemic bacterial or fungal infection at the time of surgery * Diagnosis of systemic or remote-site skin infections at time of delivery * Treatment with another investigational drug or other intervention within 7 days prior to cesarean delivery or 42 +/- 10 days after cesarean delivery * Delivery for suspected intrauterine infection (defined as maternal fever plus one clinical criteria) * Critical illness or immune-compromising disease (eg acquired immunodeficiency syndrome) * Chronic steroid use * Pre-operatively assessed to have a CDC Wound Classification of: Class III (Contaminated): Open, fresh, accidental wounds, and/or major breaks in sterile technique or gross spillage from the gastrointestinal tract * OR - Class IV (Dirty-Infected): Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera * High-risk for anesthesia (American Society of Anesthesiologists \[ASA\] class P4 - P6) * Intra-operative hemorrhage requiring blood transfusion, disseminated-intravascular coagulopathy (DIC) or any other medical or surgical condition during the Cesarean section deemed by the investigator to pose a prohibitively high risk for surgical re-exploration * Unable to speak or understand English, with no interpreter available.