Background/Aims: Although negative-pressure wound therapy (NPWT) is likely advantageous for wound healing, the efficacy and safety of its prophylactic use remain unclear for digestive surgery. We performed a prospective randomized controlled study to evaluate the efficacy and safety of this procedure during ileostomy closure. Methods: We conducted a prospective, randomized study between November 2014 and September 2015. Patients with ulcerative colitis scheduled to undergo ileostomy closure with purse-string suture (PSS) were randomly divided into groups with or without NPWT. The primary endpoint was complete wound healing. The secondary endpoints were incidences of wound complications. Results: A total of 31 patients with PSS alone and 28 patients with PSS + NPWT were enrolled. Wound infection was observed in 1 patient in the PSS-alone condition and 3 patients in the PSS + NPWT condition (p = 0.76). The mean duration of complete wound healing was 37.6 ± 11.7 days in the PSS-alone condition and 33.5 ± 10.0 days in the PSS + NPWT condition (p = 0.18). Conclusion: Although no adverse effects were observed in this series, the efficacy of PSS + NPWT was not confirmed. Further clarification of the indication of prophylactic NPWT and its efficacy must be obtained, and the efficacy and safety of NPWT in different dirty/infected surgeries should be evaluated.

Combined oral and intravenous antimicrobial prophylaxis in patients with Crohn disease contributed to the prevention of SSI.

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Background: Almost all surgeries for ulcerative colitis (UC) are performed under immunosuppressive conditions. Immunomodulators or biologics, with the exception of corticosteroids, do not appear to be risk factors for post-operative infectious complications. However, many patients are on multiagent immunosuppressive therapy at the time of surgery. Therefore, we evaluated the influence of pre-operative multiple immunosuppressives on the occurrence of surgical site infection (SSI) in UC. Methods: We reviewed surveillance data from 181 patients who underwent restorative proctocolectomy between January 2012 and March 2014. The incidences of SSI and the possible risk factors among patients receiving different immunosuppressive therapies were compared and analyzed. Results: The incidence of incisional (INC) SSI was 13.3% and that of organ/space (O/S) SSI was 7.2%. The number of immunosuppressives did not significantly correlate with each incidence. Total prednisolone administration ≥12,000 mg (OR 2.6) and an American Society of Anesthesiologists score ≥3 (OR 2.8) were shown to be independent risk factors for overall SSI, whereas corticosteroid use in INC SSI (OR 17.4) and severe disease (OR 5.2) and a large amount of blood loss (OR 3.9) in O/S SSI were identified as risk factors. Conclusion: Although a correlation between multiple immunosuppressive therapy and SSIs was not found, it is not recommended that all patients be treated with multiple immunosuppressive therapy. Treatment strategy should be applied based on the patient's condition.