{"title":"Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections in Closed Abdominal Incision: A Randomized Controlled Trial.","authors":"Maharjan Manik, Amaranathan Anandhi, Sathasivam Sureshkumar, Andi Rajendharan Keerthi, Mahalingam Sudharshan, Vikram Kate","doi":"10.1089/wound.2023.0052","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to evaluate the efficacy of prophylactic negative pressure wound therapy (PNPWT) in reducing the incidence of surgical site infection (SSI) and other wound complications in closed abdominal incisions. <b>Approach:</b> This was a prospective, single-center, open-label parallel arm superiority randomized controlled trial conducted over 2 years. Participants were randomly assigned to PNPWT and standard surgical dressing (SSD) group. The occurrence of postoperative SSI within 30 days, other wound-related complications, length of hospital (LOH) stay, and readmission within 1 month among both the study group were studied. <b>Results:</b> A total of 140 participants were included, with 70 each randomized to the PNPWT and SSD groups. In this study, 28.5% and 5.8% developed SSI in the SSD and PNPWT groups, respectively (relative risk = 0.26; 95% confidence interval = 0.08-0.80; <i>p</i> = 0.001). Similarly, the incidence of seroma (7.2% vs. 18.5%, <i>p</i> = 0.016), wound dehiscence (0% vs. 4.2%, <i>p</i> = 0.244), superficial and deep SSI (5.7% vs. 24.3%, <i>p</i> = 0.001) and (0% vs. 4.2%, <i>p</i> = 0.244), and LOH stay (days) (9 vs. 10.5, <i>p</i> = 0.07) were less in PNPWT compared to SSD group. <b>Innovation:</b> Despite the advances in surgical care, SSI rates continue to be high. The present findings might facilitate the use of PNPWT as a novel preventive strategy to reduce SSI in closed abdominal incision. <b>Conclusion:</b> The PNPWT in closed incisions following elective laparotomy can reduce the incidence of SSI when compared to SSD. The use of PNPWT was associated with a lower incidence of superficial SSI and seroma but without significant reduction in hospital stay. <b>Clinical Trial Registry India:</b> CTRI/2020/11/028795.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"123-130"},"PeriodicalIF":5.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in wound care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/wound.2023.0052","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to evaluate the efficacy of prophylactic negative pressure wound therapy (PNPWT) in reducing the incidence of surgical site infection (SSI) and other wound complications in closed abdominal incisions. Approach: This was a prospective, single-center, open-label parallel arm superiority randomized controlled trial conducted over 2 years. Participants were randomly assigned to PNPWT and standard surgical dressing (SSD) group. The occurrence of postoperative SSI within 30 days, other wound-related complications, length of hospital (LOH) stay, and readmission within 1 month among both the study group were studied. Results: A total of 140 participants were included, with 70 each randomized to the PNPWT and SSD groups. In this study, 28.5% and 5.8% developed SSI in the SSD and PNPWT groups, respectively (relative risk = 0.26; 95% confidence interval = 0.08-0.80; p = 0.001). Similarly, the incidence of seroma (7.2% vs. 18.5%, p = 0.016), wound dehiscence (0% vs. 4.2%, p = 0.244), superficial and deep SSI (5.7% vs. 24.3%, p = 0.001) and (0% vs. 4.2%, p = 0.244), and LOH stay (days) (9 vs. 10.5, p = 0.07) were less in PNPWT compared to SSD group. Innovation: Despite the advances in surgical care, SSI rates continue to be high. The present findings might facilitate the use of PNPWT as a novel preventive strategy to reduce SSI in closed abdominal incision. Conclusion: The PNPWT in closed incisions following elective laparotomy can reduce the incidence of SSI when compared to SSD. The use of PNPWT was associated with a lower incidence of superficial SSI and seroma but without significant reduction in hospital stay. Clinical Trial Registry India: CTRI/2020/11/028795.
期刊介绍:
Advances in Wound Care rapidly shares research from bench to bedside, with wound care applications for burns, major trauma, blast injuries, surgery, and diabetic ulcers. The Journal provides a critical, peer-reviewed forum for the field of tissue injury and repair, with an emphasis on acute and chronic wounds.
Advances in Wound Care explores novel research approaches and practices to deliver the latest scientific discoveries and developments.
Advances in Wound Care coverage includes:
Skin bioengineering,
Skin and tissue regeneration,
Acute, chronic, and complex wounds,
Dressings,
Anti-scar strategies,
Inflammation,
Burns and healing,
Biofilm,
Oxygen and angiogenesis,
Critical limb ischemia,
Military wound care,
New devices and technologies.