Faculty Collaboration Database

Negative pressure therapy is effective in abdominal incision closure. J Surg Res 2016 Jun 15;203(2):491-4

Date

07/02/2016

Pubmed ID

27363660

DOI

10.1016/j.jss.2016.04.032

Scopus ID

2-s2.0-84971301605 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: CDC wound classification demonstrates surgical site infection (SSI) occurs in 15%-30% of contaminated (class III) and >30% of dirty-infected (class IV) wounds. Several techniques have been used to decrease SSI rates in midline laparotomy incisions; however, no technique has shown superiority. Evidence suggests incisional negative pressure wound therapy (INPWT) can decrease wound complications, but no literature exists regarding INPWT for high-risk laparotomy incisions. We sought to analyze the efficacy of INPWT in the management of high-risk midline laparotomy incisions.

METHODS: Retrospective review of adult patients who underwent laparotomy between January 2013 and June 2014 with midline closure using INPWT. Only class III or IV wounds were included. Laparotomy incisions were loosely closed. INPWT set at 125 mm Hg is placed over oil emulsion impregnated gauze. INPWT is removed after 5 d and the wound left open to air. Records were reviewed for immediate and/or delayed surgical site complications. Primary end point was 30-d incisional SSI. Secondary end points included other surgical site complications.

RESULTS: One class III and 12 class IV wounds were treated with INPWT for a median of 5 d. The class III wound developed a small skin dehiscence with no evidence of superficial or deep SSI. Among class IV wounds, the rate of superficial and deep incisional SSI was 25% and 0%, respectively. The overall surgical site complication rate was 41.7%.

CONCLUSIONS: INPWT in closure of high-risk midline laparotomy incisions is a safe, effective method of wound closure with equivalent SSI rates to previously described methods.

Author List

Kugler NW, Carver TW, Paul JS

Authors

Thomas W. Carver MD Associate Professor in the Surgery department at Medical College of Wisconsin
Nathan W. Kugler MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Follow-Up Studies
Humans
Laparotomy
Male
Middle Aged
Negative-Pressure Wound Therapy
Retrospective Studies
Surgical Wound Infection
Treatment Outcome