[Prevention of vascular surgical site infections in the groin with negative pressure wound therapy].

Abstract

Introduction: The role of negative pressure wound therapy in the treatment of chronic, difficult-to-heal, infected wounds is becoming increasingly significant. The site most susceptible to infection following vascular surgery is the longitudinal incision wound in the groin. The following factors are predisposing factors for the development of wound infection: diabetes, obesity, previous surgery in the region, lower limb gangrene and ulcers. Objective: The objective of this study was to investigate whether closed incision negative pressure wound therapy reduces the incidence of surgical site infections and wound healing disorders in high-risk patients and whether closed incision negative pressure wound therapy reduces septic graft formation. Method: A total of 38 patients who met at least one of the inclusion criteria (body mass index >30, previous surgery in the same region, wound necrosis) were included in the study. The control group (n = 19) was treated with conventional wound coverage (Cosmopor E). In the closed incision negative pressure wound therapy group (n = 19), the primarily closed wound was covered with polyvinyl alcohol foam (VivanoMed White Foam) intraoperatively, then sealed with an airtight foil. Once the port of the vacuum machine had been connected, wound suction was initiated immediately (continuous suction, 100 mmHg). The duration of treatment was 7 days. Patients were followed up postoperatively at 10, 30, and 60 days. Results: In the control group, 42.1% of patients (n = 8) developed wound healing defects, and 36.8% (n = 7) developed surgical site infection. One patient underwent reoperation for septic graft formation. In the closed incision negative pressure wound therapy group, 31.6% (n = 6) of the patients developed wound healing problem, and 26.3% (n = 5) developed infection; in one case reoperation was performed due to septic graft formation. Conclusion: Regarding the primary endpoint, no notable discrepancies were observed between the examined groups. The results of this study demonstrate that closed incision negative pressure wound therapy may be advantageous over conventional wound care in obese patients and in those who have undergone previous inguinal surgery. A potential avenue for further investigation would be to implement more rigorous inclusion criteria. Orv Hetil. 2024; 165(42): 1652–1658.