Negative-Pressure Therapy in the Postoperative Treatment of Incisional Hernioplasty Wounds

Olona, Carles; Duque, Enric; Caro, Aleidis; Jiménez, Andrea; Moreno, Fernando Mendoza; Coronas, Jose María; Vicente, Vicente

doi:10.1097/01.asw.0000442873.48590.b5

Cited by 19 publications

(13 citation statements)

References 14 publications

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“…Our review found a number of case studies, case series and non‐randomised controlled trials that described ciNPT use. These studies included high‐risk patients with one or more comorbidities who underwent various surgical procedures, including vascular bypass, sternotomy and caesarean section . In 2013, Condé‐Green et al reported that patients undergoing abdominal hernia repairs treated with ciNPT had a lower surgical site occurrence (SSO) rates (22% versus 63%, P = 0·02) and dehiscence (9% versus 38%, P = 0·014) compared with patients treated with wound dressings .…”

Section: Resultsmentioning

confidence: 99%

“…Since 2004, numerous randomised controlled trials and individual cohort studies have described ciNPT use (see Table ). These studies encompass various wound types and surgical interventions, including traumatic injury repair, cardiothoracic surgery, lower extremity amputations, arthroplasty, hernioplasty and vascular surgery . Enrolled patients often had comorbidities, including obesity (BMI ≥30 kg/m 2 ), diabetes mellitus, peripheral vascular disease or chronic obstructive pulmonary disease .…”

Section: Resultsmentioning

confidence: 99%

“…This adverse effect was most likely because of improper dressing configuration and too high tension when using the dressing as no other study reported adverse effects. The majority of randomised controlled trials reported uniformly decreased SSI incidence, wound dehiscence and seroma development in the ciNPT‐treated group versus the control groups . Stannard et al examined outcomes in 249 patients undergoing an orthopaedic procedure for blunt trauma, resulting in 263 tibial plateau, pilon or calcaneus fractures .…”

Section: Resultsmentioning

confidence: 99%

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Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Willy

Agarwal

Andersen

et al. 2016

International Wound Journal

159

151

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Surgical site occurrences (SSOs) affect up to or over 25% of patients undergoing operative procedures, with the subset of surgical site infections (SSIs) being the most common. Commercially available closed incision negative pressure therapy (ciNPT) may offer surgeons an additional option to manage clean, closed surgical incisions. We conducted an extensive literature search for studies describing ciNPT use and assembled a diverse panel of experts to create consensus recommendations for when using ciNPT may be appropriate. A literature search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using key words 'prevention', 'negative pressure wound therapy (NPWT)', 'active incisional management', 'incisional vacuum therapy', 'incisional NPWT', 'incisional wound VAC', 'closed incisional NPWT', 'wound infection', and 'SSIs' identified peer-reviewed studies published from 2000 to 2015. During a multidisciplinary consensus meeting, the 12 experts reviewed the literature, presented their own ciNPT experiences, identified risk factors for SSOs and developed comprehensive consensus recommendations. A total of 100 publications satisfied the search requirements for ciNPT use. A majority presented data supporting ciNPT use. Numerous publications reported SSI risk factors, with the most common including obesity (body mass index ≥30 kg/m 2 ); diabetes mellitus; tobacco use; or prolonged surgical time. We recommend that the surgeon assess the individual patient's risk factors and surgical risks. Surgeons should consider using ciNPT for patients at high risk for developing SSOs or who are undergoing a high-risk procedure or a procedure that would have highly morbid consequences if an SSI occurred.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Willy

Agarwal

Andersen

et al. 2016

International Wound Journal

159

151

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“…12,13 The Prevena Incision Management System (Kinetics Concepts Inc [KCI], an Acelity Company, San Antonio, Texas) is a commercially available negative-pressure wound therapy (NPWT) device designed for the treatment of closed wounds. The first studies to evaluate this NPWT system were performed in surgical disciplines other than general surgery (including vascular, cardiothoracic, and orthopedic surgery) and mainly for the reduction of SSI in clean interventions.…”

Section: Introductionmentioning

confidence: 99%

Negative-Pressure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal

Cantero

Rubio-Perez

León

et al. 2016

Advances in Skin &Amp; Wound Care

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“…27 These studies found that the use of incisional negative pressure therapy immediately after surgery decreased the number of SSIs, 12,13,16,17,19 overall wound complications, 13,15,17,27 seroma formation, 24,25 and complications requiring repeat surgery. 14,15,20 Also noted were reduced length of stay in hospital 18,27 and in intensive care unit, 20 reduced wound drainage, 21,[24][25][26] and time needed for dressing changes. 25,27 Finally, shortened time for drain removal 26 and increased ability to self-care 18 have also been identified.…”

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confidence: 99%

Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction

Papp

2018

International Wound Journal

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Complications after pressure ulcer reconstruction are common. A complication rate of 21% to 58% and a 27% wound recurrence has been reported. The aim of this study was to decrease postoperative wound‐healing complications with incisional negative pressure wound therapy (iNPWT) postoperatively. This was a prospective non‐randomised trial with a historic control. Surgically treated pressure ulcer patients receiving iNPWT were included in the prospective part of the study (Treatment group) and compared with the historic patient cohort of all consecutive surgically treated pressure ulcer patients during a 2‐year period preceding the initiation of iNPWT (Control). There were 24 patients in the Control and 37 in the Treatment groups. The demographics between groups were similar. There was a 74% reduction in in‐hospital complications in the Treatment group (10.8% vs 41.7%, P = 0.0051), 27% reduction in the length of stay (24.8 vs 33.8 days, P = 0.0103), and a 78% reduction in the number of open wounds at 3 months (5.4 vs 25%, P = −0.0481). Recurrent wounds and history of previous surgery were risk factors for complications. Incisional negative pressure wound therapy shortens hospital stay, number of postoperative complications, and the number of recurrent open wounds at 3 months after reconstructive pressure ulcer surgery, resulting in significant cost savings.

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Negative-Pressure Therapy in the Postoperative Treatment of Incisional Hernioplasty Wounds

Cited by 19 publications

References 14 publications

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Closed incision negative pressure therapy: international multidisciplinary consensus recommendations

Negative-Pressure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal

Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction

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