Negative Pressure Wound Therapy to Treat Hematomas and Surgical Incisions Following High-Energy Trauma

Stannard, James P.; Robinson, James T.; Anderson, Erica; McGwin, Gerald; Volgas, David A.; Alonso, Jorge E.

doi:10.1097/01.ta.0000195996.73186.2e

Cited by 249 publications

(252 citation statements)

References 34 publications

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“…The incidence of SSI in 2012 was 0.10% (1/964). Application of NPWT to a closed incision has been shown to reduce incidence of infection and dehiscence [7,8]. Although none of the year by year changes is significant, the overall change in incidence of SSI from 2.13% to 0.1% is a statistically significant reduction (p < 0.0001).…”

Section: Resultsmentioning

confidence: 82%

A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

Hickson

Harris

Brett

2015

Surgical Infections

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Background: Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre-and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. Methods: A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre-and post-operative protocols, post-operative nanocrystalline silver antimicrobial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007-2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. Results: The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (p < 0.0001). There were no substantial changes in the patient population risk factors over this time. As a result of the changes in incision management practice, a total of 92 cesarean post-operative SSIs were avoided: A total cost saving of nearly $5,000,000. Conclusion: Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI.

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Section: Resultsmentioning

confidence: 82%

A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

Hickson

Harris

Brett

2015

Surgical Infections

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“…[31][32][33] The usefulness was also shown in the management of fasciotomies in of our patients which received NPWT followed by closure either by secondary intent or by skin grafting. 34 DeFranzo and colleagues reported a case series that observed NPWT applied to decreased edema of open fractures and decreased circumference of the extremity and size of the wound; 95% of wounds were successfully closed. 34 Other studies have also used NPWT for managing the fasciotomy wounds.…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound therapy: eleven-year experience at a tertiary care hospital

et al. 2017

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Background: Management of complicated wounds is a reconstructive challenge. A reconstructive surgeon has to be ready to face new challenges every day. Negative pressure wound therapy has revolutionized the management of complex wounds. We are presenting our experience with this wound care modality in the past 11 years.Methods: It was a prospective study conducted from January 2006 to December 2016 on patients having wounds of varied etiologies, who consented to participate in this study. Custom made low cost NPWT was used till definitive wound closure.Results: A total of 568 patients consented to participate in the study during these 11 years. No major complications were seen. Most of these were males (60.73%) in their 3rd and 4th decade. Trauma was the leading cause of wounds in 38.14%, followed by diabetic foot wounds in 21.5%. Ankle and foot was the most common site of wounds (30.92%) followed by leg (24.01%). A total of 322 small, 218 medium and 97 large size dressings were used. Most of the patients improved with the NPWT. No major complications were seen.Conclusions: NPWT is safe, effective and has proved to be revolutionary in managing difficult wounds. With the use of customized low cost NPWT the benefit can be extended to underprivileged population in under developed nations too.

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“…Despite this, another recent study suggested that NPWT was associated with a reduction in the size of post-operative seromas after total hip arthroplasty 37 . Moreover, Stannard et al 38 undertook a RCT investigating NPWT versus pressure dressing or standard post operative dressing in high-risk lower extremity fractures and concluded that NPWT reduced the duration of drainage in patients with haematomas or high-risk lower limb fractures compared with controls (mean 1.6 days versus 3.1 days for haematomas, p=0.03; and 1.8 days versus 4.8 days for high-risk fractures, p=0.02) 38 .…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review

et al. 2013

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Negative Pressure Wound Therapy to Treat Hematomas and Surgical Incisions Following High-Energy Trauma

Cited by 249 publications

References 34 publications

A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

Negative pressure wound therapy: eleven-year experience at a tertiary care hospital

Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review

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