Negative Pressure Wound Therapy Versus Closed Suction Irrigation System in the Treatment of Deep Surgical Site Infection After Lumbar Surgery

Zeng, Junkai; Sun, Xiaojiang; Sun, Zhenyu; Gao, Jie; Chen, Han; Zhao, Xin; Zhang, Pu; Xie, Yubing; Zhao, Jie

doi:10.1016/j.wneu.2019.03.130

Cited by 28 publications

(22 citation statements)

References 39 publications

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“…17,19,29 Negative pressure suction with irrigation has been reported to be an efficient technique for the management of deep SSI. 30 Therefore, negative pressure drainage with irrigation is becoming a main trend in the prevention and treatment of complicated deep SSI.…”

Section: Discussionmentioning

confidence: 99%

Continuous Negative Pressure Drainage with Intermittent Irrigation Leaded to a Risk Reduction of Perineal Surgical Site Infection Following Laparoscopic Extralevator Abdominoperineal Excision for Low Rectal Cancer

Han

Yang

Wang

et al. 2021

TCRM

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Purpose High rate of perineal surgical site infection (SSI) is the most common complication following abdominoperineal resection (APR), especially for extralevator abdominoperineal excision (ELAPE). The purpose of this study was to investigate the effect of continuous negative pressure drainage combined with intermittent irrigation (CNPDCII) in the presacral space on the perineal SSI following laparoscopic ELAPE for low rectal cancer. Patients and Methods The clinical data of 99 patients with low rectal cancer who underwent laparoscopic ELAPE surgery were retrospectively analyzed. Among the 99 patients, 46 patients received CNPDCII and 53 patients received conventional drainage in the presacral space after ELAPE. Self-made irrigation drainage tube: took a silicone drainage tube, cut 3 side holes at every 2cm intervals at the front end, and fixed a flexible tube of an intravenous needle at the front end of the silicone drainage tube. The conventional drainage tube or self-made irrigation drainage tube was placed in the presacral space and poked out from the inside of the ischial tuberosity. The incidence of SSI and other perioperative indicators between the two groups was compared within 30 days after surgery. Results There was no statistical difference in clinicopathological features between the two groups of patients (p>0.05). A statistically lower rate of SSI was found in CNPDCII group (17.4%, 8/46) than the conventional drainage group (35.8%, 19/53). The drainage tube retention time (7.8±1.2 d VS 9.4±1.6 d) and the postoperative hospital stay (9.7±1.4 d VS 11.9±2.3 d) in CNPDCII group were significantly shortened than the conventional drainage group. There was no statistical difference in operating theatre time and intraoperative blood loss between the two groups. Multivariate analysis confirmed that CNPDCII was an independent protective factor for SSI after ELAPE. Conclusion CNPDCII can effectively reduce the incidence of SSI following laparoscopic ELAPE, which is simple, safe and effective.

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Section: Discussionmentioning

confidence: 99%

Continuous Negative Pressure Drainage with Intermittent Irrigation Leaded to a Risk Reduction of Perineal Surgical Site Infection Following Laparoscopic Extralevator Abdominoperineal Excision for Low Rectal Cancer

Han

Yang

Wang

et al. 2021

TCRM

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“…Although advances have been made in infection control practices, the incidence of SSI after posterior cervical surgery ranges from 1.3-14%, Several risk factors for SSI in posterior cervical spine surgeries are increasingly being investigated. Many estimated risk factors have been reported in previous studies, such as advanced age, higher body mass index (BMI > 30 kg/m 2 ), smoking, diabetes, malnutrition (preoperative albumin level < 3.5 g/dL), history of infection in the surgical site, preoperative steroid therapy, blood loss, implant, and prolonged operative time (> 3 hours) [11][12][13][14][15][16] . Meanwhile, bacterial culture indicated that the most common causative microorganisms of SSI in spinal surgery are Staphylococcus aureus and other members of Staphylococcus species 17,18 .…”

Section: Introductionmentioning

confidence: 99%

The risk factors of surgical site infection following posterior cervical spine surgery

Chang

Yang

et al. 2021

Preprint

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Background: Surgical site infection (SSI) is a common complication following posterior cervical spine surgery, imposing a high burden on patients and society. However, information about its characteristics and related risk factors is limited. We designed this study intended to address this issue.Methods: From January 2011 through October 2020, a total of 405 patients diagnosed of cervical degenerative diseases (cervical spondylotic myelopathy, ossification of posterior longitudinal ligament and cervical disk herniation) who were treated with unilateral open-door lamnioplasty surgeries were enrolled in this study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analyses were performed to determine risk factors. Results: There were significant differences between groups in subcutaneous fat thickness (FT) (P<0.001), ratio of subcutaneous FT to muscle thickness (MT) (P<0.001), preoperative Japanese Orthopaedic Association（JOA）Scores (P< 0.003), preoperative serum albumin (P< 0.001), postoperative drainage (P<0.004), time of draining (P<0.001). Logistic regression analysis of these differences showed that ratio of subcutaneous FT/MT, preoperative JOA score, preoperative serum albumin and longer time of draining were significantly related to SSI (P<0.05).Conclusion: Ratio of subcutaneous FT/MT, preoperative JOA score, preoperative serum albumin and longer time of draining are identified as the independent risk factors of SSI in posterior cervical spine surgeries. Identification of these risk factors could be useful in reducing SSI incidence and patients counseling.

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“…Studies in other surgical specialties have shown the benefits incurred by closed incision negative pressure therapy (ciNPT) include lower incidence of SSI, seroma formation, and re‐operation rates following soft tissue closure 10,11 . The use of NPWT in spine surgery has traditionally been in the treatment of post‐operative wound complications, including SSI 12,13 . More recently, it has been suggested that the use of ciNPT may reduce the incidence of SSI following spinal fusion procedures 14,15 .…”

Section: Introductionmentioning

confidence: 99%

“…10,11 The use of NPWT in spine surgery has traditionally been in the treatment of post-operative wound complications, including SSI. 12,13 More recently, it has been suggested that the use of ciNPT may reduce the incidence of SSI following spinal fusion procedures. 14,15 However, its potential applications in spinal surgery needs further clarification.…”

mentioning

confidence: 99%

Negative pressure wound therapy in spinal fusion patients

Akhter

McGahan

et al. 2020

International Wound Journal

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Post-operative wound complications are some of the most common acute complications following spine surgery. These surgical site infections (SSI) contribute to increased healthcare related costs. Negative pressure wound therapy (NPWT) has long been used for treatment of soft tissue injury or defects. NPWT may reduce the incident of SSI following spinal fusion procedures; however, its potential applications need further clarification. Thus, we conducted a retrospective analysis of two cohorts to compare NPWT to traditional sterile dressings following spinal fusions in regards to post-operative outcomes. Following institutional review board approval, 42 patients who had a NPWT were matched by type of surgery to 42 patients who had traditional dressings. A retrospective chart-review was completed. Outcome measures, particularly SSI and need for reoperation, were analyzed using one-way ANOVA for both univariate and multivariate analysis. When controlled for sex and body-mass index, the use of a NPWT was independently correlated with decreased SSI (P = .035). Superficial dehiscence, seroma, need for additional outpatient care, and need for operative revision were all found to occur at higher rates in the traditional dressing cohort. Closed incisional negative pressure wound therapy provides a cost-effective method of decreasing surgical site infection for posterior elective spine surgeries.

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Negative Pressure Wound Therapy Versus Closed Suction Irrigation System in the Treatment of Deep Surgical Site Infection After Lumbar Surgery

Cited by 28 publications

References 39 publications

Continuous Negative Pressure Drainage with Intermittent Irrigation Leaded to a Risk Reduction of Perineal Surgical Site Infection Following Laparoscopic Extralevator Abdominoperineal Excision for Low Rectal Cancer

Continuous Negative Pressure Drainage with Intermittent Irrigation Leaded to a Risk Reduction of Perineal Surgical Site Infection Following Laparoscopic Extralevator Abdominoperineal Excision for Low Rectal Cancer

The risk factors of surgical site infection following posterior cervical spine surgery

Negative pressure wound therapy in spinal fusion patients

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