Effect of closed incision negative pressure wound therapy on incidence rate of surgical site infection after stoma reversal: a pilot study.

Abstract

Introduction:The stoma reversal (SR) procedure is associated with a relatively high risk of perioperative complications with surgical site infection (SSI) as the most common. Recently closed incision negative pressure wound therapy (ciNPWT) was applied widely to prevent SSI. Aim: To investigate the efficiency of ciNPWT in terms of the incidence rate of SSI after SR surgery. Material and methods: As an exploratory observational cohort study patients were treated either with ciNPWT (n = 15) or standard sterile dressing (SSD) (n = 15). CiNPWT was applied every 3 days whereas SSD was changed every day. Clinical evaluation for SSI signs, C-reactive protein level and pain assessment using the visual analogue scale (VAS) were analyzed. Results: The incidence rate of SSI was in 13% (2/15) in the ciNPWT group and 26% (4/15) in the SSD group (p = 0.651, OR = 0.44, 95% CI: 0.03-3.73). All patients in the SSD group who developed SSI presented both local and generalized signs of infection. Pain-VAS levels assessed on the 1 st (MdnciNPWT = 4, MdnSSD = 5, p = 0.027, W = 51.5) and 3 rd postoperative day (MdnciNPWT = 2, MdnSSD = 4, p = 0.014, W = 45.5) were significantly lower in the ciNPWT group than in the SSD group. Conclusions: CiNPWT seems not to have a benefit to reduce SSI after the SR procedure. Further investigation is needed to establish firmly the benefit of using ciNPWT in this group of patients.

Post‐operative nursing activities to prevent wound complications in patients undergoing colorectal surgeries: A scoping review

“…Nurses were tasked with maintaining euglycaemia (Hewitt et al., 2017; Keenan et al., 2014, 2015; Martinez et al., 2020; Reese et al., 2020; Shakeshaft et al., 2020; Tanner et al., 2016); the exact timing of these activities was not explicit (Shakeshaft et al., 2020) except for one study, where an insulin infusion continued for 48 h post operation, after which diabetic patients returned to usual medications (Shakeshaft et al., 2020). Nurses also administered antibiotics 8‐hourly (Carrano et al., 2021; León Arellano et al., 2021), and antibiotics continued for 24 h post operation (Borejsza‐Wysocki et al., 2021; Carrano et al., 2021; León Arellano et al., 2021; Webb et al., 2019).…”

“…The most frequent interventions/quality improvement initiatives were negative pressure wound pressure therapy (NWPT) (Abadía et al., 2021; Borejsza‐Wysocki et al., 2021; Carrano et al., 2021; Chadi et al., 2014; Curchod et al., 2022; Curran et al., 2019; León Arellano et al., 2021; Murphy et al., 2019; Ocaña Jiménez et al., 2019; Okuya et al., 2020; Pellino, Sciaudone, Candilio, Campitiello, et al., 2014; Pellino, Sciaudone, Candilio, de Fatico, et al., 2014; Poehnert et al., 2017; Selvaggi et al., 2014; Uchino et al., 2016; Webb et al., 2019; Wierdak et al., 2021) and SSI bundles (Cima et al., 2013; D'Souza et al., 2019; Gorgun et al., 2018; Hewitt et al., 2017; Keenan et al., 2014, 2015; Martinez et al., 2020; Park et al., 2020; Reese et al., 2020; Tanner et al., 2016). We found no interventions/quality improvement initiatives with nursing activities exclusively occurring in the postoperative phase; activities also occurred in the pre‐ and intraoperative phases, and all interventions/quality improvement initiatives had multidisciplinary input (see Table 3).…”

“…‘Technical procedure and delegated medical care’ was the most frequent dimension of care undertaken by nurses ( n = 63 activities) (see Table 5). Within this domain, wound management activities were common, such as removal of NWPT (Abadía et al., 2021; Carrano et al., 2021; Chadi et al., 2014; Curchod et al., 2022; Curran et al., 2019; León Arellano et al., 2021; Murphy et al., 2019; Ocaña Jiménez et al., 2019; Okuya et al., 2020; Pellino, Sciaudone, Candilio, Campitiello, et al., 2014; Pellino, Sciaudone, Candilio, de Fatico, et al., 2014; Poehnert et al., 2017; Selvaggi et al., 2014; Uchino et al., 2016; Webb et al., 2019; Wierdak et al., 2021), removal of other dressings (Ahmad et al., 2019; Cima et al., 2013; D'Souza et al., 2019; Gorgun et al., 2018; Hewitt et al., 2017; Keenan et al., 2014, 2015; Park et al., 2020; Reese et al., 2020; Ruiz‐Tovar et al., 2015; Ruiz‐Tovar et al., 2019; Siah & Yatim, 2011), dressing changes (Borejsza‐Wysocki et al., 2021; Pan et al., 2015; Pellino, Sciaudone, Candilio, Campitiello, et al., 2014; Pellino, Sciaudone, Candilio, de Fatico, et al., 2014; Selvaggi et al., 2014; Siah & Yatim, 2011; Wierdak et al., 2021) and removal of staples and sutures (León Arellano et al., 2021; Pan et al., 2015; Siah & Yatim, 2011; Wierdak et al., 2021) (see Table 3). Dressing removal activities ranged from postoperative day (POD) 2 to POD 14.…”

“…Tovar et al, 2019;Siah & Yatim, 2011), dressing changes(Borejsza-Wysocki et al, 2021;Pan et al, 2015;Pellino, Sciaudone, Candilio, de Fatico, et al, 2014;Selvaggi et al, 2014;Siah & Yatim, 2011;Wierdak et al, 2021) and removal of staples and sutures (LeónArellano et al, 2021;Pan et al, 2015;Siah & Yatim, 2011;Wierdak et al, 2021) (see Table3). Dressing removal activities ranged from postoperative day (POD) 2 to POD 14.…”

“…Wounds were cleansed daily in some studies(Keenan et al, 2014(Keenan et al, , 2015Reese et al, 2020). NWPT dressings were changed at POD 3(Borejsza-Wysocki et al, 2021;Pellino, Sciaudone, Candilio, de Fatico, et al, 2014;Selvaggi et al, 2014) or when gauzes were too wetPellino, Sciaudone, Candilio, de Fatico, et al, 2014;Selvaggi et al, 2014), and other dressings were changed as needed(Siah & Yatim, 2011) (see Table3). 'Application of medicinal treatment' was the second most frequent dimension of care (n = 11 activities).…”