S Acosta1, M Björck2, A Wanhainen2. 1. Department of Clinical Sciences, Vascular Centre, Lund University, Malmö, Sweden. 2. Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. CONCLUSION: NPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. CONCLUSION: NPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.
Authors: Kai Siang Chan; Muthaiah Arunaachalam; Qiantai Hong; En Ming Yong; Pravin Lingam; Li Zhang; Sadhana Chandrasekar; Glenn Wei Leong Tan; Zhiwen Joseph Lo Journal: Int Wound J Date: 2020-04-29 Impact factor: 3.315
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Authors: Joan Webster; Zhenmi Liu; Gill Norman; Jo C Dumville; Laura Chiverton; Paul Scuffham; Monica Stankiewicz; Wendy P Chaboyer Journal: Cochrane Database Syst Rev Date: 2019-03-26
Authors: Gill Norman; En Lin Goh; Jo C Dumville; Chunhu Shi; Zhenmi Liu; Laura Chiverton; Monica Stankiewicz; Adam Reid Journal: Cochrane Database Syst Rev Date: 2020-05-01
Authors: Joseph D Bozzay; Patrick F Walker; David W Schechtman; Faraz Shaikh; Laveta Stewart; David R Tribble; Matthew J Bradley Journal: J Surg Res Date: 2020-08-29 Impact factor: 2.192
Authors: Gill Norman; En Lin Goh; Jo C Dumville; Chunhu Shi; Zhenmi Liu; Laura Chiverton; Monica Stankiewicz; Adam Reid Journal: Cochrane Database Syst Rev Date: 2020-06-15