Reducing Surgical Site Infection with Negative-Pressure Wound Therapy After Open Abdominal Surgery: A Prospective Randomized Controlled Study

Li, Ping; Yang, Donghong; Liu, D.; Sun, Suwendong; Zhang, L.-Y.

doi:10.1177/1457496916668681

Cited by 58 publications

(75 citation statements)

References 31 publications

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“…A meta‐analysis of Semsarzadeh and colleagues indicated SSSI rates after abdominal surgery of 0% (cesarean section; 8.3% with SSD) to 20.4% (ventral hernia; 25.8% with SSD) . Li et al reported SSSI rates of 4% (iNPWT) vs. 31% (SSD; p = 0.028) in patients undergoing abdominal surgery . Blackham et al announced SSSI rates of 6.7% (iNPWT) vs. 17.2% (SSD) ( p = 0.035) in patients operated due to abdominal carcinoma .…”

Section: Discussionmentioning

confidence: 99%

Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy

Poehnert

Hadeler

Schrem

et al. 2017

Wound Repair Regeneration

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This single-center prospective, controlled observational study investigates the impact of incisional negative pressure wound therapy on wound healing processes and its potency to prevent superficial surgical site infections (SSSI) after reversal of a double loop ileostomy. Furthermore, this study gains insight in socioeconomic aspects, like duration of hospital stay and, for the first time, patient's quality of life during the incisional negative pressure wound treatment. To address this question, an interventional group of 24 patients treated with incisional negative pressure wound therapy (Prevena incisional wound management system, KCI, Germany) and a respective control cohort of 25 patients treated with a standard sterile dressing were observed for 30 days in the postoperative course. Postoperative incisional negative pressure wound therapy resulted in statistically significant decreasing duration of hospital stay (6 days vs. 9 days, p 5 0.019) and lower rates of SSSIs (12.5% vs. 20.0%, p 5 0.478) in accordance with a not statistically significant decreased necessity of postoperative antibiotic therapy (12.5% vs. 36%, p 5 0.051). To survey subjective items of well-being and quality of life, all patients were asked to answer a questionnaire. Patients of both groups noticed increasing quality of life after reversal of their ileostomy. However, patients treated with an incisional negative pressure wound therapy had a superior improvement of a variety of subjective items, resulting in an overall much better satisfaction with the course of wound healing. Our findings suggest, that incisional negative pressure wound therapy seems to be a reasonable therapeutic option to reduce incidence of SSSIs and to have a beneficial impact to patient's quality of life, as well as, socio-economic aspects.

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Section: Discussionmentioning

confidence: 99%

Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy

Poehnert

Hadeler

Schrem

et al. 2017

Wound Repair Regeneration

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“…Guidelines on antibiotic prophylaxis provide recommendations for selection of the appropriate antimicrobial for each surgical intervention [28]. However, the antibiotic is not always enough to reduce the virulence for bacterial (very often polymicrobial) in infecting the surgical sites very often it is necessary to resort to advanced medications such as vac, silver dressings and etc [21,29]. Without a doubt the difference in results between children and the elderly in skin healing is due to a biological-anatomical factor.…”

Section: Discussionmentioning

confidence: 99%

Children vs elderly in orthopedic surgery site of infection. Are there difference? Experience of a high volume plastic surgeon consultant.

Franzese¹,

Conte²,

Gagliardo³

et al. 2020

Acta Med Sal

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Introduction: Prevention of surgical site infection in surgery and bone trauma has some hallmarks not shared with other surgical disciplines. The surgeon is not always able to open the pathogen and a key to correct therapy. The aim of our work is to verify if there are differences between pathogens, and treatment between the two groups most susceptible to skin infections by means of synthesis such as children and the elderly. Materials and Methods: From January 2011 to december 2018, we perform 3189 consultancies in various departments of orthopedics and traumatology. From the exclusion criteria we recruited 168 patients with superficial infection of the surgical site after orthopedic surgery. A group represented by children (under 12 years old) and a group of older people over 65. The evaluation criteria between the two groups were: the infectious bacterial flora; the type of antibiotic, the duration of antibiotic therapy; the type of medications used in the post-operative period, the complications.Results:The results showed that elderly patients are more likely to be bacterial superinfection due to poor hygiene. Therapy in children is shorter and has minor complications. Proper management of the surgical site showed a rapid resolution of the infection in both groups. Conclusion: The correct management and hygiene of the surgical site allows its rapid recovery from infection. The plastic surgeon management of the fracture site infection can be a winning weapon in the treatment of this problem both in the child and in the elderly.

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“…One of the potential solutions that could help to achieve these goals may be the extensive and early use of Negative Pressure Wound Therapy (NPWT) devices in the prevention of wound healing complications 3 (mainly surgical site infections -SSI 4 or wound dehiscence), particularly among higher-risk patients, 5 those with complex incisions with ort without prosthetic devices underlying the closed incision. [6][7][8] Li et al proved that patients undergoing NPWT after open abdominal surgery had SSI less frequently 9 and the formation of enteroatmospheric fistulae were also less frequent in patients receiving. 10 The relative liberal use of ciNPWT, may well be advantageous for patients who are discharged as an inpatient earlier than normal to free up capacity for acute COVID beds may continue to receive good quality healthcare at home.…”

Section: General Strategymentioning

confidence: 99%

Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

Banasiewicz

Becker²,

Bobkiewicz

et al. 2020

NPWTJ

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Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care.

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Reducing Surgical Site Infection with Negative-Pressure Wound Therapy After Open Abdominal Surgery: A Prospective Randomized Controlled Study

Abstract: Negative-pressure wound therapy can reduce the incidence of surgical site infection in open abdominal surgery.

Cited by 58 publications

References 31 publications

Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy

Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy

Children vs elderly in orthopedic surgery site of infection. Are there difference? Experience of a high volume plastic surgeon consultant.

Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

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