Surgical Wound Complications after Colorectal Surgery with Single-Use Negative-Pressure Wound Therapy Versus Surgical Dressing over Closed Incisions: A Randomized Controlled Trial

Abstract

BACKGROUND Global studies indicate that surgical site infections (SSIs) are a major healthcare challenge within hospitals and can have a profound impact on patient quality of life and healthcare costs. Closed-incision negative-pressure therapy (ciNPT) has been reported to provide positive clinical benefits for patients with various incisions, including those following colorectal surgeries. METHODS Investigators performed a prospective, randomized, multicenter trial to evaluate complications of surgical incisions in patients who received a ciNPT dressing versus a conventional surgical dressing (control) over their closed incision following colorectal surgery. The incidence of SSI was determined at 7, 15, and 30 days postsurgery. RESULTS A total of 148 patients participated in the study. Results showed that the SSI rate on day 7 was lower in the ciNPT group versus the control group (10/75 [13.3%] vs 17/73 [23.3%]), but this difference was not statistically significant. On day 15, the SSI rate was 12/75 (16.0%) in the ciNPT group versus 21/73 (28.8%) in the control group; however, this difference was only marginally statistically significant (P = .0621). At 1 month, the SSI rate remained lower in the ciNPT group (13/75 [17.3%] vs 21/73 [28.8%], P = .0983) compared with the control group. CONCLUSIONS Future studies with larger population sizes are necessary to determine the impact of ciNPT on patients’ incisions after colorectal surgery.

Closed Incision Negative Pressure Therapy versus Standard of Care in Reduction of Surgical Site Complications: A Systematic Review and Meta-analysis

“…The 84 studies identified encompassed cardiac surgery (n = 8), general abdominal surgery (n = 21), obstetric and gynecologic surgery (n = 8), orthopedic surgery (n = 16), plastic surgery (n = 16), and vascular surgery (n = 15). 11–16,20–97…”

“…Dressings used in the SOC population varied and included gauze dressings, antimicrobial hydrofiber dressings, absorbent dressings, hydrocolloid dressings, occlusive dressings, or foam dressings. 11–16,20–97…”

Does Prophylactic Negative‐Pressure Wound Therapy Prevent Surgical Site Infection After Laparotomy? A Systematic Review and Meta‐analysis of Randomized Controlled trials

“…The number of patients per RCT ranged between 40 [ 33 ] and 505 [ 32 ]. Studies were published recently, one in 2016 [ 21 ], two in 2017 [ 18 , 20 ], two in 2019 [ 17 , 19 ], three in 2020 [ 30 , 31 , 33 ] and three in 2021 [ 29 , 32 , 34 ]. Four RCTs were performed in the USA [ 17 , 21 , 32 , 33 ], two in Australia [ 31 , 34 ], two in Spain [ 29 , 30 ], one in Canada [ 19 ], one in Ireland [ 20 ] and one in China [ 18 ].…”

“…Studies were published recently, one in 2016 [ 21 ], two in 2017 [ 18 , 20 ], two in 2019 [ 17 , 19 ], three in 2020 [ 30 , 31 , 33 ] and three in 2021 [ 29 , 32 , 34 ]. Four RCTs were performed in the USA [ 17 , 21 , 32 , 33 ], two in Australia [ 31 , 34 ], two in Spain [ 29 , 30 ], one in Canada [ 19 ], one in Ireland [ 20 ] and one in China [ 18 ]. Four RCTs included patients who underwent abdominal/digestive surgery [ 18 , 20 , 21 , 31 ], two included patients who had hepato-biliary surgery [ 17 , 33 ], two included patients who underwent colorectal surgery [ 19 , 29 ], one included patients who had incisional hernia repair [ 30 ], one included patients who underwent laparotomy for gynaecologic surgery [ 32 ], and one included patients who had general surgery [ 34 ].…”

“…Four RCTs were performed in the USA [ 17 , 21 , 32 , 33 ], two in Australia [ 31 , 34 ], two in Spain [ 29 , 30 ], one in Canada [ 19 ], one in Ireland [ 20 ] and one in China [ 18 ]. Four RCTs included patients who underwent abdominal/digestive surgery [ 18 , 20 , 21 , 31 ], two included patients who had hepato-biliary surgery [ 17 , 33 ], two included patients who underwent colorectal surgery [ 19 , 29 ], one included patients who had incisional hernia repair [ 30 ], one included patients who underwent laparotomy for gynaecologic surgery [ 32 ], and one included patients who had general surgery [ 34 ]. Four RCTs considered patients who underwent elective and emergency surgical interventions [ 20 , 29 , 31 , 34 ], and six RCTs only included elective patients [ 17 , 19 , 21 , 30 , 32 , 33 ].…”