A M Di Re1, D Wright2, J W T Toh3, T El-Khoury4, N Pathma-Nathan5, M P Gosselink6, S Khanijaun5, S Raman7, G Ctercteko8. 1. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; School of Physics, University of Sydney, Sydney, NSW, Australia. Electronic address: Angelina.dire@gmail.com. 2. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; Department of Surgery, Blacktown-Mount Druitt Hospital, Mount Druitt, NSW, Australia. 3. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; School of Medicine, University of Sydney, Sydney, NSW, Australia. 4. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; School of Medicine, Notre Dame University, Sydney, NSW, Australia. 5. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia. 6. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; Dr. Horacio E. Oduber Hospital, Aruba. 7. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 8. Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia; Department of Surgery, Blacktown-Mount Druitt Hospital, Mount Druitt, NSW, Australia; School of Medicine, University of Sydney, Sydney, NSW, Australia.
Abstract
BACKGROUND: Surgical site infections (SSIs) are the most common cause of healthcare-associated infections in surgical patients. It is unclear whether incisional negative pressure wound therapy (NPWT) can reduce the risk of SSIs in patients after open abdominal surgery. METHODS: A prospective, non-blinded multi-centre randomized controlled trial (RCT) was performed to evaluate the incidence of SSI post-laparotomy using incisional NPWT compared with a standard dressing. The primary outcome was the rate of superficial SSI. RESULTS: A total of 124 patients (61 patients in the NPWT arm and 63 patients in the control arm) were included. One hundred and nine (87.9%) patients underwent colorectal surgery; 61 patients (49.2%) had emergency surgery. There were more superficial SSIs in the control group than in the NPWT group, although not statistically significant (20.6% vs 9.8%, P=0.1). Upon multiple logistic regression analysis, control dressings were associated with increased risk of superficial SSI although again, not statistically significant (odds ratio (OR) 2.41, 95% confidence interval (CI) 0.81-7.17, P=0.11). There was no superficial non-SSI related wound dehiscence in the NPWT group compared with 9.5% in the control group (P=0.03). There was no difference in postoperative complications (P=0.15), nor in other wound complications (P=0.79). CONCLUSION:NPWT was not associated with decreased superficial SSI in this RCT. However, there was a statistically significant reduction in superficial wound dehiscence with NWPT dressings. The results of this study should be included in meta-analyses for better evaluation of NPWT on closed abdominal incisions. Crown
RCT Entities:
BACKGROUND: Surgical site infections (SSIs) are the most common cause of healthcare-associated infections in surgical patients. It is unclear whether incisional negative pressure wound therapy (NPWT) can reduce the risk of SSIs in patients after open abdominal surgery. METHODS: A prospective, non-blinded multi-centre randomized controlled trial (RCT) was performed to evaluate the incidence of SSI post-laparotomy using incisional NPWT compared with a standard dressing. The primary outcome was the rate of superficial SSI. RESULTS: A total of 124 patients (61 patients in the NPWT arm and 63 patients in the control arm) were included. One hundred and nine (87.9%) patients underwent colorectal surgery; 61 patients (49.2%) had emergency surgery. There were more superficial SSIs in the control group than in the NPWT group, although not statistically significant (20.6% vs 9.8%, P=0.1). Upon multiple logistic regression analysis, control dressings were associated with increased risk of superficial SSI although again, not statistically significant (odds ratio (OR) 2.41, 95% confidence interval (CI) 0.81-7.17, P=0.11). There was no superficial non-SSI related wound dehiscence in the NPWT group compared with 9.5% in the control group (P=0.03). There was no difference in postoperative complications (P=0.15), nor in other wound complications (P=0.79). CONCLUSION: NPWT was not associated with decreased superficial SSI in this RCT. However, there was a statistically significant reduction in superficial wound dehiscence with NWPT dressings. The results of this study should be included in meta-analyses for better evaluation of NPWT on closed abdominal incisions. Crown