Kevin C Soares1, Pablo A Baltodano1, Caitlin W Hicks1, Carisa M Cooney2, Israel O Olorundare2, Peter Cornell1, Karen Burce1, Frederic E Eckhauser3. 1. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: feckhau2@jhmi.edu.
Abstract
BACKGROUND: Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR. METHODS: A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings. Multivariable logistic regression compared surgical site infections, surgical site occurrences, morbidity, and reoperation rates. RESULTS: We evaluated 199 patients (115 HVAC vs 84 standard wound dressing patients). Mean follow-up was 9 months. The HVAC cohort had lower surgical site infections (9% vs 32%, P < .001) and surgical site occurrences (17% vs 42%, P = .001) rates. Rates of major morbidity (19% vs 31%, P = .04) and 90-day reoperation (5% vs 14%, P = .02) were lower in the HVAC cohort. CONCLUSIONS: The HVAC system is associated with optimized outcomes following open VHR. Prospective studies should validate these findings and define the economic implications of this intervention.
BACKGROUND: Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR. METHODS: A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings. Multivariable logistic regression compared surgical site infections, surgical site occurrences, morbidity, and reoperation rates. RESULTS: We evaluated 199 patients (115 HVAC vs 84 standard wound dressing patients). Mean follow-up was 9 months. The HVAC cohort had lower surgical site infections (9% vs 32%, P < .001) and surgical site occurrences (17% vs 42%, P = .001) rates. Rates of major morbidity (19% vs 31%, P = .04) and 90-day reoperation (5% vs 14%, P = .02) were lower in the HVAC cohort. CONCLUSIONS: The HVAC system is associated with optimized outcomes following open VHR. Prospective studies should validate these findings and define the economic implications of this intervention.
Authors: S C Azoury; N Rodriguez-Unda; K C Soares; C W Hicks; P A Baltodano; K E Poruk; Q L Hu; C M Cooney; P Cornell; K Burce; F E Eckhauser Journal: Hernia Date: 2015-07-08 Impact factor: 4.739
Authors: Shaheel Mohammad Sahebally; Kevin McKevitt; Ian Stephens; Fidelma Fitzpatrick; Joseph Deasy; John Patrick Burke; Deborah McNamara Journal: JAMA Surg Date: 2018-11-21 Impact factor: 14.766
Authors: F K Azar; T C Crawford; K E Poruk; N Farrow; P Cornell; O Nadra; S C Azoury; K C Soares; C M Cooney; F E Eckhauser Journal: Hernia Date: 2017-02-08 Impact factor: 4.739
Authors: Edward W Swanson; Hsu-Tang Cheng; Srinivas M Susarla; Denver M Lough; Anand R Kumar Journal: Plast Surg (Oakv) Date: 2016-05-27 Impact factor: 0.947
Authors: Shadi Lalezari; Christine J Lee; Anna A Borovikova; Derek A Banyard; Keyianoosh Z Paydar; Garrett A Wirth; Alan D Widgerow Journal: Int Wound J Date: 2016-09-29 Impact factor: 3.315
Authors: Katherine E Poruk; Joseph A Lin; Michol A Cooper; Jin He; Martin A Makary; Kenzo Hirose; John L Cameron; Timothy M Pawlik; Christopher L Wolfgang; Frederic Eckhauser; Matthew J Weiss Journal: HPB (Oxford) Date: 2016-09-10 Impact factor: 3.647