Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy

Abstract

Purpose Traditionally, previous wound infection was considered a contraindication to secondary skin closure; however, several case reports describe successful secondary wound closure of wounds “preconditioned” with negative pressure wound therapy (NPWT). Although this has been increasingly applied in daily practice, a systematic analysis of its feasibility has not been published thus far. The aim of this study was to evaluate secondary skin closure in previously infected abdominal wounds following treatment with NPWT. Methods Single-center retrospective analysis of patients with infected abdominal wounds treated with NPWT followed by either secondary skin closure referenced to a group receiving open wound therapy. Endpoints were wound closure rate, wound complications (such as recurrent infection or hernia), and perioperative data (such as duration of NPWT or hospitalization parameters). Results One hundred ninety-eight patients during 2013–2016 received a secondary skin closure after NPWT and were analyzed and referenced to 67 patients in the same period with open wound treatment after NPWT. No significant difference in BMI, chronic immunosuppressive medication, or tobacco use was found between both groups. The mean duration of hospital stay was 30 days with a comparable duration in both patient groups (29 versus 33 days, p = 0.35). Interestingly, only 7.7% of patients after secondary skin closure developed recurrent surgical site infection and in over 80% of patients were discharged with closed wounds requiring only minimal outpatient wound care. Conclusion Surgical skin closure following NPWT of infected abdominal wounds is a good and safe alternative to open wound treatment. It prevents lengthy outpatient wound therapy and is expected to result in a higher quality of life for patients and reduce health care costs.

Auswirkung von COVID-19 auf die elektive und notfallmäßige Kolorektalchirurgie

“…Für Deutschland zeigte sich im 1. Lockdown eine Reduktion von Appendektomien um 12–18 % [ 18 ]. Insgesamt hat die COVID-Pandemie daher ein einzigartiges Umfeld bereitgestellt, um fundamentale Fragen in der Therapie der akuten Appendizitis zu evaluieren, z.…”

Hybrid suture coating for dual-staged control over antibacterial actions to match well wound healing progression

“…Surgical site infections (SSI) frequently take occur in postsurgical or other medical-related procedures, which is as high as 12.5% in patients. 5,6 SSIs are implicated in many complications including retarded wound recovery, operation failure and even the life-threatening risk, leading to unwanted economical and physiological burdens. Of note, surgically implanted materials have been identified as one of the major contributory factors in SSIs, 7 particularly for skin suture because of their long-term exposure to nonsterile environments.…”

Secondary wound closure with a new transparent negative pressure dressing

“…Nach der Konditionierung und Débridement des Wundgrundes kann der sekundäre Wundverschluss operativ mit einer chirurgischen Naht erfolgen. Die kutane Unterdrucktherapie wird auch präventiv nach primärer chirurgischer Naht angewendet [ 1 – 3 ]. Beschreibungen für sekundäre Wundverschlüsse ohne eine chirurgische Naht sind bislang nicht bekannt.…”