Incisional Negative-Pressure Wound Therapy for Perineal Wounds After Abdominoperineal Resection for Rectal Cancer, a Pilot Study

Valk, Maxime J M van der; Graaf, Eelco J. R. de; Doornebosch, Pascal G.; Vermaas, Maarten

doi:10.1089/wound.2017.0749

Cited by 20 publications

(19 citation statements)

References 14 publications

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“…Included studies were composed of three congress abstracts [ 18 – 20 ] and four original publications [ 14 – 17 ]. All of them were recent, two being published in 2014 [ 14 , 20 ], one in 2016 [ 15 ], two in 2017 [ 16 , 17 ], and two in 2018 [ 18 , 19 ]. All of them were cohort studies [ 14 – 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…All of them were cohort studies [ 14 – 20 ]. Six studies compared perineal wound outcomes between patients with pNPWT and those with conventional wound dressing [ 14 – 16 , 18 – 20 ]. Control patients were historical in 3 studies [ 14 – 16 ] (Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…All studies included patients undergoing APR [ 14 – 20 ] or pelvic exenteration [ 14 , 17 , 18 ]. Surgical indication was mainly rectal cancer [ 14 – 17 ], but two studies also included patients suffering from inflammatory bowel disease [ 14 , 16 ]. Application of biological mesh to close the perineal defect and/or use of drain was poorly documented and varied among studies (Tables 3 and 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Application of biological mesh to close the perineal defect and/or use of drain was poorly documented and varied among studies (Tables 3 and 4 ). In patients with application of pNPWT on closed perineum, the device used was the PREVENA incision management system (KCI, Acelity, San Antonio, USA) set at − 100 mmHg [ 17 ] or for 5 days [ 20 ] and the PICO single use negative pressure wound therapy system (Smith & Nephew, Hertfordshire, UK) set at − 80 mmHg for 4–8 days [ 16 ] or unknown commercial device set at − 125 mmHg for 5 days [ 14 , 15 ].…”

Section: Resultsmentioning

confidence: 99%

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The role of perineal application of prophylactic negative-pressure wound therapy for prevention of wound-related complications after abdomino-perineal resection: a systematic review

Meyer¹,

Röös

Abbassi³

et al. 2020

Int J Colorectal Dis

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Background Closed perineal wounds often fail to heal by primary intention after abdomino-perineal resection (APR) and are often complicated by surgical site infection (SSI) and/or wound dehiscence. Recent evidence showed encouraging results of prophylactic negative-pressure wound therapy (pNPWT) for prevention of wound-related complications in surgery. Our objective was to gather and discuss the early existing literature regarding the use of pNPWT to prevent wound-related complications on perineal wounds after APR. Methods Medline, Embase, and Web of Science were searched for original publications and congress abstracts reporting the use of pNPWT after APR on closed perineal wounds. Results Seven publications were included for analysis. Two publications reported significantly lower incidence of SSI in pNPWT patients than in controls with a risk reduction of about 25–30%. Two other publications described similar incidences of SSI between the two groups of patients but described SSI in pNPWT patients to be less severe. One study reported significantly lower incidence of wound dehiscence in pNPWT patients than in controls. Conclusion The largest non-randomized studies investigating the effect of pNPWT on the prevention of wound-related complications after APR showed encouraging results in terms of reduction of SSI and wound dehiscence that deserve further investigation and confirmation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The role of perineal application of prophylactic negative-pressure wound therapy for prevention of wound-related complications after abdomino-perineal resection: a systematic review

Meyer¹,

Röös

Abbassi³

et al. 2020

Int J Colorectal Dis

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“…For primary closed perineal wounds following RA, NPWT was associated with a reduced incidence of perineal SSI compared with only a gauze dressing [38]. On the other hand, van der Valk MJM et al [39] reported in a pilot study that incisional NPWT decreased the duration of wound healing but did not reduce the rate of wound complications. The significance of NPWT for PWC following RA is still unknown.…”

Section: Discussionmentioning

confidence: 98%

What is the advantage of rectal amputation with an initial perineal approach for primary anorectal carcinoma?

et al. 2020

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Background: Rectal amputation (RA) remains an important surgical procedure for salvage despite advances in sphincter-preserving resection, including intersphincteric resection. The aim of this study was to compare shortand long-term outcomes of RA with an initial perineal approach to those of RA with an initial abdominal approach (conventional abdominoperineal resection (APR)) for primary anorectal cancer. Methods:We retrospectively analyzed the short-and long-term outcomes of 48 patients who underwent RA with an initial perineal approach (perineal group) and 21 patients who underwent RA with an initial abdominal approach (conventional group).Results: For the perineal group, the operation time was shorter than that for the conventional group (313 vs. 388 min, p = 0.027). The postoperative complication rate was similar between the two groups (43.8 vs. 47.6%, p = 0.766). Perineal wound complications (PWCs) were significantly fewer in the perineal group than in the conventional group (22.9 vs. 57.1%, p = 0.006). All 69 patients underwent complete TME, but positive CRM was significantly higher in the conventional group than in the perineal group (0 vs. 19.0%, p = 0.011). There were no significant differences in the recurrence (43.8 vs. 47.6%, p = 0.689), 5-year disease-free survival (63.7% vs. 56.7%, p = 0.665) and 5-year overall survival rates (82.5% vs. 66.2%, p = 0.323) between the two groups. Conclusion: These data suggest that RA with an initial perineal approach for selective primary anorectal carcinoma is advantageous in minimizing PWCs and positive CRMs. Further investigations on the advantages of this approach are necessary.

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Infection in Surgery: How to Manage the Surgical Wound

Foghetti

2021

Infections in Surgery

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Incisional Negative-Pressure Wound Therapy for Perineal Wounds After Abdominoperineal Resection for Rectal Cancer, a Pilot Study

Cited by 20 publications

References 14 publications

The role of perineal application of prophylactic negative-pressure wound therapy for prevention of wound-related complications after abdomino-perineal resection: a systematic review

The role of perineal application of prophylactic negative-pressure wound therapy for prevention of wound-related complications after abdomino-perineal resection: a systematic review

What is the advantage of rectal amputation with an initial perineal approach for primary anorectal carcinoma?

Infection in Surgery: How to Manage the Surgical Wound

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