Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations

O’Leary, Donal Peter; Peirce, Colin; Anglim, Breffini; Burton, Michael D.; Concannon, Elizabeth; Carter, Marguerite; Hickey, Kevin; Coffey, J. Calvin

doi:10.1097/sla.0000000000002098

Cited by 112 publications

(120 citation statements)

References 25 publications

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“…The LOS was reported in eight studies representing 725 patients [ 28 , 29 , 31 , 36 , 39–41 ]. There was a significant mean difference in LOS from PICO single-use NPWT treatment compared with standard care (−0.47 days [95% CI −0.71 to −0.23] p < 0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…The detail of each individual study and the overall data and subgroup analysis (as a forest plot) is shown in Figure 5 . A subgroup analysis was performed on the basis of surgical speciality, and mean difference in LOS was −5.1 days in colorectal/laparotomy surgical procedures [ 39–41 ] but only −0.1 days in all other operations [ 28 , 29 , 31 , 36 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications

Strugala¹,

Martin²

2017

Surgical Infections

125

109

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Background: We report the first meta-analysis on the impact of prophylactic use of a specific design of negative pressure wound therapy (NPWT) device on surgical site complications.Methods: Articles were identified in which the specific single-use NPWT device (PICO⋄, Smith & Nephew) was compared with standard care for surgical site infection (SSI), dehiscence, or length of stay (LOS). Risk ratio (RR) ±95% confidence interval (CI) (SSI; dehiscence) or mean difference in LOS ±95% CI was calculated using RevMan v5.3.Results: There were 1863 patients (2202 incisions) represented by 16 articles. Among 10 randomized studies, there was a significant reduction in SSI rate of 51% from 9.7% to 4.8% with NPWT intervention (RR 0.49 [95% CI 0.34–0.69] p < 0.0001). There were six observational studies assessing reduction in SSI rate of 67% from 22.5% to 7.4% with NPWT (RR 0. 32 [95% CI 0.18–0.55] p < 0.0001). Combining all 16 studies, there was a significant reduction in SSI of 58% from 12.5% to 5.2% with NPWT (RR 0.43 [95% CI 0.32–0.57] p < 0.0001). Similar effects were seen irrespective of the kind of surgery (orthopedic, abdominal, colorectal, or cesarean section), although the numbers needed to treat (NNT) were lower in operations with higher frequencies of complications. There was a significant reduction in dehiscence from 17.4% to 12.8% with NPWT (RR 0.71 [95% CI 0.54–0.92] p < 0.01). The mean reduction in hospital LOS by NPWT was also significant (−0.47 days [95% CI −0.71 to −0.23] p < 0.0001).Conclusions: The significant reduction in SSI, wound dehiscence, and LOS on the basis of pooled data from 16 studies shows a benefit of the PICO single-use NPWT system compared with standard care in closed surgical incisions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications

Strugala¹,

Martin²

2017

Surgical Infections

125

109

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“…Numerous trials and meta-analyses have confirmed a benefit of NPWT in adult patients who underwent abdominal surgery. 13.5% in contaminated, and 14.6% in dirty/infected wounds. 18 Bhattacharyya and Kosloske studied prospectively 676 consecutive patients and found an overall infection rate of 2.5% ranging from 1.0% in clean wounds, 2.9% in clean-contaminated, 7.9% in contaminated, and 6.3% in dirty wounds.…”

Section: Discussionmentioning

confidence: 94%

“…stay 13. NPWT has been successfully used in orthopedic,14 cardiothoracic,15 and abdominal16 closed surgical incisions.…”

mentioning

confidence: 99%

Negative Pressure Wound Dressing Reduces Surgical Site Infections in Infants after Closed Abdominal Procedures: A Preliminary Report

et al. 2018

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“…A total of 35 articles discussed prophylactic VSD (pVSD) for abdominal incisions with primary suture, of which 6 were RCTs 32 , 33 , 34 , 35 , 36 , 37 and 29 were observational studies. 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 …”

Section: Recommendationsmentioning

confidence: 99%

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

Sun

et al. 2019

Chinese Journal of Traumatology

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Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2–4. Weak recommendations were made regarding questions 1 and 5–11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

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Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations

Abstract: Prophylactic use of negative pressure dressings for closed laparotomy wounds significantly reduces the incidence of SSI at 30 days postoperatively.

Cited by 112 publications

References 25 publications

Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications

Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications

Negative Pressure Wound Dressing Reduces Surgical Site Infections in Infants after Closed Abdominal Procedures: A Preliminary Report

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

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