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Comparison of surgical site infection (SSI) between negative pressure wound therapy (NPWT) assisted delayed primary closure and conventional delayed primary closure in grossly contaminated emergency abdominal surgeries: a randomized controlled trial.
Singh, Pradeep Kumar; Sethi, Mahesh Kumar; Mishra, Tushar Subhadarshan; Kumar, Pankaj; Ali, S Manwar; Sasmal, Prakash Kumar; Mishra, Swastik Sourav.
Afiliación
  • Singh PK; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
  • Sethi MK; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India. maheshsethi949@gmail.com.
  • Mishra TS; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
  • Kumar P; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
  • Ali SM; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
  • Sasmal PK; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
  • Mishra SS; Department of General Surgery, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
Langenbecks Arch Surg ; 409(1): 19, 2023 Dec 27.
Article en En | MEDLINE | ID: mdl-38150073
ABSTRACT

PURPOSE:

NPWT has been tried in many surgical fields, including colorectal, thoracic, vascular, and non-healing wounds, for the prevention of SSI. However, its efficacy in the prevention of SSI-grade IV closed abdominal wounds is yet to be explored.

METHODS:

All patients with grade IV abdominal wounds were included in the study. They were randomized into the conventional arm and the VAC arm after confirming the diagnosis intra-operatively. The sheath was closed, and the skin was laid open in the postoperative period. In the VAC arm, the NPWT dressing was applied on postoperative day (POD)-1 and removed on POD-5. In the conventional arm, only regular dressing was done postoperatively. The skin was closed with a delayed primary intention on POD-5 in both arms. The sutures were removed after 7 to 10 days of skin closure.

RESULTS:

The rate of SSI (10% in the VAC arm vs. 37.5% in the conventional arm, p-value = 0.004) was significantly lower in the VAC arm, as were the rates of seroma formation (2.4% in the VAC arm vs. 20% in the conventional arm, p = 0.014) and wound dehiscence (7.3% vs. 30%, p = 0.011). The conventional arm had a significant delay in skin closure beyond POD5 due to an increased rate of SSI, which also led to a prolonged hospital stay (5 days in the VAC arm vs. 6.5 days in the conventional arm, p-value = 0.005).

CONCLUSION:

The VAC dressing can be used routinely in grade IV closed abdominal wounds to reduce the risk of SSI and wound dehiscence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Presión Negativa para Heridas / Traumatismos Abdominales Límite: Humans Idioma: En Revista: Langenbecks Arch Surg Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Presión Negativa para Heridas / Traumatismos Abdominales Límite: Humans Idioma: En Revista: Langenbecks Arch Surg Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: Alemania