Rebecca Gologorsky1, Shruti Arora2, Anahita Dua3. 1. Department of Surgery, University of California San Francisco-East Bay, Oakland. 2. Stanford University School of Medicine, CA. 3. Department of Surgery, Massachusetts General Hospital, Boston.
Abstract
INTRODUCTION: Abdominoperineal resection is associated with a high rate of wound complications. A high degree of wound tension, a common contributor to wound breakdown and complications, may be mitigated by incisional negative-pressure wound therapy (NPWT). Although NPWT has been shown to reduce complications associated with open and complex wounds, there is a paucity of data regarding its prophylactic use for incisional wounds. OBJECTIVE: To determine the effect of NPWT use on surgical wound complications of abdominoperineal resection for malignancy. METHODS: We performed a systematic review by querying the PubMed database for studies from 1990 to 2019 and included English-language studies that used incisional NPWT for closed wounds from abdominoperineal resection in malignancy cases. RESULTS: Five studies with a total of 76 patients were included. Their findings showed reduced rates of surgical site complications with the use of incisional NPWT. Another 2 studies describing the use of prophylactic NPWT to expedite secondary closure of the surgical wound followed by incisional wound therapy were separately categorized and included 8 patients, none of whom experienced wound wound complications. DISCUSSION: Additional, prospective research is needed to confirm the benefit of prophylactic incisional NPWT.
INTRODUCTION: Abdominoperineal resection is associated with a high rate of wound complications. A high degree of wound tension, a common contributor to wound breakdown and complications, may be mitigated by incisional negative-pressure wound therapy (NPWT). Although NPWT has been shown to reduce complications associated with open and complex wounds, there is a paucity of data regarding its prophylactic use for incisional wounds. OBJECTIVE: To determine the effect of NPWT use on surgical wound complications of abdominoperineal resection for malignancy. METHODS: We performed a systematic review by querying the PubMed database for studies from 1990 to 2019 and included English-language studies that used incisional NPWT for closed wounds from abdominoperineal resection in malignancy cases. RESULTS: Five studies with a total of 76 patients were included. Their findings showed reduced rates of surgical site complications with the use of incisional NPWT. Another 2 studies describing the use of prophylactic NPWT to expedite secondary closure of the surgical wound followed by incisional wound therapy were separately categorized and included 8 patients, none of whom experienced wound wound complications. DISCUSSION: Additional, prospective research is needed to confirm the benefit of prophylactic incisional NPWT.
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