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. 2019 Jan;21(1):110-118.
doi: 10.1111/codi.14350. Epub 2018 Aug 20.

Prophylactic closed-incision negative-pressure wound therapy is associated with decreased surgical site infection in high-risk colorectal surgery laparotomy wounds

T Curran  1 , D Alvarez  1 , J Pastrana Del Valle  1 , T E Cataldo  1 , V Poylin  1 , D Nagle  1
Affiliations

Prophylactic closed-incision negative-pressure wound therapy is associated with decreased surgical site infection in high-risk colorectal surgery laparotomy wounds

T Curran et al. Colorectal Dis. 2019 Jan.

Abstract

Aim: Surgical site infection in colorectal surgery is associated with significant healthcare costs, which may be reduced by using a closed-incision negative-pressure therapy device. The aim of this study was to assess the impact of closed-incision negative-pressure therapy on the incidence of surgical site infection.

Method: In this retrospective cohort study we evaluated all patients who had undergone high-risk open colorectal surgery at a single tertiary care centre from 2012 to 2016. We compared the incidence of surgical site infection between those receiving standard postoperative wound care between 2012 and 2014 and those receiving closed-incision negative-pressure therapy via a customizable device (Prevena Incision Management System, KCI, an Acelity company, San Antonio, Texas, USA) between 2014 and 2016. A validated surgical site infection risk score was used to create a 1:1 matched cohort subset.

Results: Negative pressure therapy was used in 77 patients and compared with 238 controls. Negative pressure patients were more likely to have a stoma (92% vs 48%, P < 0.01) and to be smokers (33% vs 15%, P < 0.01). Surgical site infection was higher in control patients (15%, n = 35/238) compared with negative pressure patients (7%, n = 5/77) (P = 0.05). On regression analysis, negative pressure therapy was associated with decreased surgical site infection (OR 0.27; 95% CI 0.09-0.78). These differences persisted in the matched analysis.

Conclusion: Negative pressure therapy was associated with decreased surgical site infection. Negative pressure therapy offers significant potential for quality improvement.

Keywords: Closed incision negative pressure therapy; quality improvement; surgical site infection.

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Figures

Figure 1
Figure 1
Patient selection.
Figure 2
Figure 2
Surgical procedure: CINPT vs non‐CINPT.
Figure 3
Figure 3
Incidence of SSI: nonmatched CINPT vs non‐CINPT (DSSI, deep SSI; SSSI, superficial SSI).
Figure 4
Figure 4
Incidence of SSI: matched CINPT vs non‐CINPT (DSSI, deep SSI; SSSI, superficial SSI).
See this image and copyright information in PMC

References

    1. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009; 37: 387–97. - PubMed
    1. Kiran RP, El‐Gazzaz GH, Vogel JD, Remzi FH. Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program. J Am Coll Surg 2010; 211: 232–8. - PubMed
    1. Kelly KN, Iannuzzi JC, Aquina CT et al Timing of discharge: a key to understanding the reason for readmission after colorectal surgery. J Gastrointest Surg 2015; 19: 418–27; discussion 27‐8. - PubMed
    1. Wick EC, Shore AD, Hirose K et al Readmission rates and cost following colorectal surgery. Dis Colon Rectum 2011; 54: 1475–9. - PubMed
    1. Scalise A, Calamita R, Tartaglione C et al Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. A systematic review of the literature. Int Wound J 2016; 13: 1260–81. - PMC - PubMed