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Clinical Trial
. 2019 Jan 1;85(1):1-7.

Effect of Negative Pressure Wound Therapy on Wound Complications Post-Pancreatectomy

Michael P Kuncewitch, Aaron U Blackham, Clancy J Clark, Rebecca M Dodson, Gregory B Russell, Edward A Levine, Perry Shen
Clinical Trial

Effect of Negative Pressure Wound Therapy on Wound Complications Post-Pancreatectomy

Michael P Kuncewitch et al. Am Surg. .

Abstract

Surgical site infection (SSI) and incisional hernia are common complications after major pancreatectomy. We investigated the effects of negative pressure wound therapy (NPWT) on short- and long-term wound outcomes in patients undergoing pancreatectomy. A randomized controlled trial comparing the effect of NPWT with standard surgical dressing (SSD) on wounds was performed in 265 patients undergoing open gastrointestinal resections from 2012 to 2016. We performed a subset analysis of 73 patients who underwent pancreatectomy. Wound complications in the first 30 days and incisional hernia rates were assessed. There were 33 (45%) female patients in the study and the average BMI was 27.6. The pancreaticoduodectomy rate was 68 per cent, whereas 27 per cent of patients underwent distal or subtotal pancreatectomy, and 4 per cent total pancreatectomy. Incisional hernia rates were 32 per cent and 14 per cent between the SSD and NPWT groups, respectively (P = 0.067). In the SSD (n = 37) and NPWT (n = 36) cohorts, the superficial SSI, deep SSI, seroma, and dehiscence rates were 16 per cent and 14 per cent (P > 0.99), 5 per cent and 8 per cent (P = 0.67), 16 per cent and 11 per cent (P = 0.74), and 5 per cent and 3 per cent (P ≥ 0.99), respectively. After adjusting for pancreatic fistula and delayed gastric emptying, no statistically significant differences in the primary outcomes were observed. These findings were true irrespective of the type of resection performed. Short- and long-term wound complications were not improved with NPWT. We observed a trend toward decreased incisional hernia rates in patients treated with NPWT. Owing to the multifactorial nature of wound complications, it is yet to be determined which cohorts of pancreatectomy patients will benefit from NPWT.

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Figures

Fig. 1.
Fig. 1.
Incidence rates of wound complications by study arm. All P > 0.05.
Fig. 2.
Fig. 2.
Rate of postoperative complications by study arm. POPF, postoperative pancreatic fistula. All P > 0.05.
Fig. 3.
Fig. 3.
Overall rate of incisional hernia by resection type.
See this image and copyright information in PMC

References

    1. Ceppa EP, Pitt HA, House MG, et al. Reducing surgical site infections in hepatopancreatobiliary surgery. HPB (Oxford) 2013; 15:384–91. - PMC - PubMed
    1. Okano K, Hirao T, Unno M, et al. Postoperative infectious complications after pancreatic resection. Br J Surg 2015;102: 1551–60. - PubMed
    1. Sanford DE, Strasberg SM, Hawkins WG, et al. The impact of recent hospitalization on surgical site infection after a pancreatectomy. HPB (Oxford) 2015;17:819–23. - PMC - PubMed
    1. You L, Zhao W, Hong X, et al. The effect of body mass index on surgical outcomes in patients undergoing pancreatic resection: a systematic review and meta-analysis. Pancreas 2016;45:796–805. - PubMed
    1. Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725–30. - PubMed

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