Robin Visser1, Kris Milbrandt2, Suyin Lum Min2, Nathan Wiseman2, Betty-Jean Hancock2, Melanie Morris2, Richard Keijzer3. 1. Department of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada. 2. Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. 3. Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: richardkeijzer@gmail.com.
Abstract
INTRODUCTION: The prevention of surgical site infections has received little attention in pediatric surgery. Negative pressure wound therapy is used to treat complex wounds. We hypothesized that this principle could reduce wound infection rates following laparoscopic surgery. We tested this in a randomized controlled trial. MATERIALS AND METHODS: We randomized pediatric patients with an umbilical port site to astandard dressing or a vacuum dressing. The dressings were removed 48h after surgery. A nurse blinded for the treatment inspected the umbilical wound between post-operative days 7-10 for infection. Data comparison was performed using a Fisher exact test with p<0.05 defined as significant. RESULTS: We recruited 90 patients over 2 years and randomized 44 to thevacuum dressing arm and 42 to the control arm. We observed a 2.8% (n=1/35) infection rate in the vacuum dressing group and 3.3% (n=1/30) in the control group (p=1.0). DISCUSSION: We ended our study early when an interim analysis showed an impractical number of patients would be required to achieve sufficient power. We did not find a significant difference between the control and vacuum dressings in reducing post-operative wound infections. LEVEL OF EVIDENCE: 3.
RCT Entities:
INTRODUCTION: The prevention of surgical site infections has received little attention in pediatric surgery. Negative pressure wound therapy is used to treat complex wounds. We hypothesized that this principle could reduce wound infection rates following laparoscopic surgery. We tested this in a randomized controlled trial. MATERIALS AND METHODS: We randomized pediatric patients with an umbilical port site to a standard dressing or a vacuum dressing. The dressings were removed 48h after surgery. A nurse blinded for the treatment inspected the umbilical wound between post-operative days 7-10 for infection. Data comparison was performed using a Fisher exact test with p<0.05 defined as significant. RESULTS: We recruited 90 patients over 2 years and randomized 44 to the vacuum dressing arm and 42 to the control arm. We observed a 2.8% (n=1/35) infection rate in the vacuum dressing group and 3.3% (n=1/30) in the control group (p=1.0). DISCUSSION: We ended our study early when an interim analysis showed an impractical number of patients would be required to achieve sufficient power. We did not find a significant difference between the control and vacuum dressings in reducing post-operative wound infections. LEVEL OF EVIDENCE: 3.
Authors: Katherine B Santosa; Matt Keller; Margaret A Olsen; Alexandra M Keane; Erika D Sears; Alison K Snyder-Warwick Journal: J Surg Res Date: 2018-11-30 Impact factor: 2.192
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