Experience with a new negative pressure incision management system in prevention of groin wound infection in vascular surgery patients

Abstract

Objective: Groin wound infection is an important cause of postoperative morbidity in vascular surgery patients, especially when prosthetic grafts are involved. The objective of this study was to investigate if Prevena (Kinetic Concepts, Inc, San Antonio, Tex), a negative pressure incision management system, could reduce the risk of groin wound infection in patients after vascular surgery.

Methods: Ninety patients (115 groin incisions) underwent longitudinal or transverse femoral cutdown for vascular procedures. A retrospective chart review was performed on 63 consecutive incisions in patients in the non-Prevena group from December 2009 to November 2010 and on 52 consecutive incisions in patients in the Prevena group from January 2011 to December 2011. Prevena was applied intraoperatively and removed 5 to 7 days postoperatively. The non-Prevena group received either a skin adhesive or absorbent dressing. Groin incisions were assessed, and infection was graded based on Szilagyi classifications. Student t-test and two-sample proportion z test were used for statistical analyses. A P value < .05 was considered statistically significant.

Results: Comorbidities and known risk factors for infection were compared; there were no statistically significant differences between the two groups. Prosthetic material was used in 34 (65%) incisions in the Prevena group and 29 (46%) incisions in the non-Prevena group. Fifty (96%) incisions within the Prevena group and 60 (96%) in the non-Prevena group were classified as clean surgical wounds. Wounds were evaluated at 7 days and 30 days postoperatively. Of 63 groin incisions in 49 patients in the non-Prevena group, 19 (30%) incisions had groin wound infections. Wound infections were classified into Szilagyi grade I (10; 16%), Szilagyi grade II (7; 11%), and Szilagyi grade III (2; 3%). Of 52 groin incisions in 41 patients in the Prevena group, three (6%) incisions had Szilagyi grade I wound infections. No grade II or III infections occurred in this group. Overall incidence of infection between the two groups was statistically significant (P = .0011).

Conclusions: In this clinical study, Prevena negative pressure dressing significantly decreased the incidence of groin wound infection in patients after vascular surgery.