Incisional Negative Pressure Wound Therapy Significantly Reduces Surgical Site Infection in Open Colorectal Surgery

Bonds, Allison M.; Novick, Tessa K.; Dietert, Jessica B.; Araghizadeh, Farshid; Olson, Craig

doi:10.1097/dcr.0b013e3182a39959

Cited by 100 publications

(85 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several interventions to reduce wound complications have been assessed, including pre-surgical antibiotic treatment and surgical site preparation,[2, 12] maintenance of normothemia, [13, 14] subcutaneous drain placement or suture closure, [15–20] subcuticular skin closure,[21–24] retention sutures,[25] wound protection devices,[26] negative pressure dressings[27] and skin sealants. [28] The results of these studies have been conflicting; many limited to obstetrical patients or have used varying definitions of obesity.…”

Section: Introductionmentioning

confidence: 99%

A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynecologic oncology patients

Novetsky¹,

Zighelboim²,

Guntupalli³

et al. 2014

Gynecologic Oncology

View full text Add to dashboard Cite

Objectives Obese women have a high incidence of wound separation after gynecologic surgery. We explored the effect of a prospective care pathway on the incidence of wound complications. Methods Women with a body mass index (BMI)≥30kg/m2 undergoing a gynecologic procedure by a gynecologic oncologist via a vertical abdominal incision were eligible. The surgical protocol required: skin and subcutaneous tissues to be incised using a scalpel or cutting electrocautery, fascial closure using #1 polydioxanone suture, placement of a 7mm Jackson-Pratt drain below Camper’s fascia, closure of Camper’s fascia with 3-0 plain catgut suture and skin closure with staples. Wound complication was defined as the presence of either a wound infection or any separation. Demographic and perioperative data were analyzed using contingency tables. Univariable and multivariable regression models were used to identify predictors of wound complications. Patients were compared using a multivariable model to a historical group of obese patients to assess the efficacy of the care pathway. Results 105 women were enrolled with a median BMI of 38.1. Overall, 39 (37%) had a wound complication. Women with a BMI of 30–39.9 kg/m2 had a significantly lower risk of wound complication as compared to those with a BMI >40 kg/m2 (23% vs 59%, p<0.001). After controlling for factors associated with wound complications the prospective care pathway was associated with a significantly decreased wound complication rate in women with BMI<40kg/m2 (OR 0.40, 95% C.I.: 0.18–0.89). Conclusion This surgical protocol lead to a decreased rate of wound complications among women with BMI 30–39.9 kg/m2.

show abstract

Section: Introductionmentioning

confidence: 99%

A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynecologic oncology patients

Novetsky¹,

Zighelboim²,

Guntupalli³

et al. 2014

Gynecologic Oncology

View full text Add to dashboard Cite

show abstract

“…It delivers intermittent or continuous negative pressure (ranging from <50mmHg to >125mmHg) to the wound site which is covered with a foam or gauze dressing and sealed with an occlusive drape. Success has been reported in complex wounds 35 with emerging evidence to show that its use in high risk, post-operative incisions prevents SSIs [36][37][38][39][40] . The likely modes of action are through holding wound edges together (thereby reducing the likelihood of surgical dehiscence), stimulation of perfusion, reduction of lateral tension, haematoma and oedema, and protection of the surgical site from exogenous sources of micro-organisms.…”

Section: Negative Pressure Wound Therapy (Npwt)mentioning

confidence: 99%

Evidence update on prevention of surgical site infection

Leaper

Ousey

2015

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Address for correspondence: profdavidleaper@doctors.org.uk ABSTRACT Purpose of review: surgical site infection (SSI) is a common health care associated infection and complicates up to 10-20% of operations with considerable health care resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and peri-operative glycaemic control to reduce SSIs this review has considered new research and systematic reviews, and whether their findings should be included in guidelines.Recent findings: The efficacy of preoperative bathing/showering, antibiotic prophylaxis for clean surgery and perioperative oxygen supplementation to reduce the risk of SSI is still in doubt. By contrast, the use of 2% chlorhexidine in alcohol skin preparation, postoperative negative pressure wound therapy and antiseptic surgical dressings do show promise.Antimicrobial sutures in independent meta-analyses were found to reduce the risk of SSI after all classes of surgery (except dirty) whereas the use of wound guards, or diathermy skin incision (compared with scalpel incision), did not.Summary: The incidence of SSI after surgery is not falling. Based on this review of published trials and evidence-based systematic reviews some advances might be included into these care bundles. More research is needed together with improved compliance with care bundles.

show abstract

“…In such situations, NPWT is often applied. A study in 2013 showed that the use of NPWT in open colorectal surgery significantly reduces the SSI rate from 29.3% to 12.5% ( p < 0.05) [54].…”

Section: 9mentioning

confidence: 99%

Silver-based dressings for the reduction of surgical site infection: Review of current experience and recommendation for future studies

Abboud

Settle

Legare

et al. 2014

Burns

View full text Add to dashboard Cite

Incisional Negative Pressure Wound Therapy Significantly Reduces Surgical Site Infection in Open Colorectal Surgery

Cited by 100 publications

References 19 publications

A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynecologic oncology patients

A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynecologic oncology patients

Evidence update on prevention of surgical site infection

Silver-based dressings for the reduction of surgical site infection: Review of current experience and recommendation for future studies

Contact Info

Product

Resources

About