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. 2024 Feb 27:4:1352363.
doi: 10.3389/fneph.2024.1352363. eCollection 2024.

Prospective evaluation of a closed-incision negative pressure wound therapy system in kidney transplantation and its association with wound complications

Susanna Lam  1   2   3   4 , Annie Huynh  2 , Tracey Ying  1   4   5 , Charbel Sandroussi  2   3   4 , David Gracey  1   4   5 , Henry C Pleass  2   4 , Steve Chadban  1   4   5 , Jerome M Laurence  2   3   4   5
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Prospective evaluation of a closed-incision negative pressure wound therapy system in kidney transplantation and its association with wound complications

Susanna Lam et al. Front Nephrol. .

Abstract

Introduction: Wound complications can cause considerable morbidity in kidney transplantation. Closed-incision negative pressure wound therapy (ciNPWT) systems have been efficacious in reducing wound complications across surgical specialties. The aims of this study were to evaluate the use of ciNPWT, Prevena™, in kidney transplant recipients and to determine any association with wound complications.

Material and methods: A single-center, prospective observational cohort study was performed in 2018. A total of 30 consecutive kidney transplant recipients deemed at high risk for wound complications received ciNPWT, and the results were compared to those of a historical cohort of subjects who received conventional dressings. Analysis for recipients with obesity and propensity score matching were performed.

Results: In total, 127 subjects were included in the analysis. Of these, 30 received a ciNPWT dressing and were compared with 97 subjects from a non-study historical control group who had conventional dressing. The overall wound complication rate was 21.3% (27/127). There was no reduction in the rate of wound complications with ciNPWT when compared with conventional dressing [23.3% (7/30) and 20.6% (20/97), respectively, p = 0.75]. In the obese subset (BMI ≥30 kg/m2), there was no significant reduction in wound complications [31.1% (5/16) and 36.8% (7/19), respectively, p = 0.73]. Propensity score matching yielded 26 matched pairs with equivalent rates of wound complications (23.1%, 6/26).

Conclusion: This is the first reported cohort study evaluating the use of ciNPWT in kidney transplantation. While ciNPWT is safe and well tolerated, it is not associated with a statistically significant reduction in wound complications when compared to conventional dressing. The findings from this study will be used to inform future studies associated with ciNPWT in kidney transplantation.

Keywords: closed incision management; closed incision negative pressure; closed incision negative pressure wound therapy; kidney transplant; wound complication.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Supplementary material templates can be found in the Frontiers Word Templates file.

Figures

Figure 1
Figure 1
Clinical image of the closed-incision negative pressure wound therapy (ciNPWT) in situ. (A) “Prevena™” dressing applied to the kidney transplant incision in the right iliac fossa and connected to an integrated pump (not shown). (B) Wound appearance of the surgical incision after removal of ciNPWT (image obtained with patient consent).
See this image and copyright information in PMC

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