Application of PREVENA (Surgical Incision Protection System) in reducing surgical site infections following reversal of ileostomy or colostomy: the PRIC study protocol

Abstract

Aim There is a current lack of evidence in the literature to support the routine use of negative pressure wound therapy (NPWT) to reduce the risk of surgical site infections (SSI) in the setting of ileostomy or colostomy reversal. The aim of this study is to examine whether routine NPWT confers a lower rate of SSI than conventional dressings following reversal of ileostomy or colostomy. Methods The PRIC study is a randomized, controlled, open-label, multi-centre superiority trial to assess whether routine NPWT following wound closure confers a lower rate of SSI following reversal of ileostomy or colostomy when compared to conventional dressings. Participants will be consecutively identified and recruited. Eligible participants will be randomized in a 1:1 allocation ratio, to receive either the NPWT (PREVENA) dressings or conventional dressings which will be applied immediately upon completion of surgery. PREVENA dressings will remain applied for a duration of 7 days. Surgical wounds will then be examined on post-operative day seven as well as during follow-up appointments in OPD for any evidence of SSI. In the interim, public health nurses (PHN) will provide out-patient support services incorporating wound assessment and care as part of a routine basis. Study investigators will liaise with PHN to gather the relevant data in relation to the time to wound healing. Our primary endpoint is the incidence of SSI within 30 days of stoma reversal. Secondary endpoints include measuring time to wound healing, evaluating wound healing and aesthetics and assessing patient satisfaction. Conclusion The PRIC study will assess whether routine NPWT following wound closure is superior to conventional dressings in the reduction of SSI following reversal of ileostomy or colostomy and ascertain whether routine NPWT should be considered the new standard of care.

Risk factors analysis of surgical site infections in postoperative colorectal cancer: a nine-year retrospective study

“…In clinical practice, it is worth exploring strategies to mitigate the risk of surgical site infections following ileostomy or colostomy reversal. Several randomized controlled trials have substantiated the efficacy of routine employment of negative pressure wound therapy in reducing the incidence of SSIs after ileostomy or colostomy reversal [ 36 , 37 ]. The widespread adoption and practicality of this technique warrant further investigation.…”

The application of negative pressure wound therapy in orthopedics: current concepts

“…Moreover, the authors reported rapid formation of granulation tissue and reduction of bacterial load 3 . Since its introduction, several studies have compared NPWT with conventional dressing methods, reporting improved wound healing rate and time [4][5][6][7][8][9][10][11][12] , especially in general surgery. The promising effects of NPWT in complex wound healing led to a broadening of its indications 1 .…”