The efficacy of negative-pressure wound therapy (NPWT) in the prevention of surgical site occurrences in open abdominal surgery: A randomized clinical trial.

Autor: Moreno Gijón M; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: mmorensue@gmail.com., Suárez Sánchez A; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/AidukiSuarez., de Santiago Álvarez I; General Surgery Department, San Agustín Hospital, Avilés, Spain., Rodicio Miravalles JL; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/JLRodicio., Amoza Pais S; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain., Rodríguez Uría R; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/raqueluria1., Sanz Navarro S; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/Sandra_S_N., Díaz Vico T; General Surgery Department, Rey Juan Carlos University Hospital, Madrid, Spain. Electronic address: https://www.twitter.com/TamaraVico., Turienzo Santos E; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/EstrellaTurien1., Sanz Álvarez L; General Surgery Department, Asturias Central University Hospital (HUCA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain. Electronic address: https://www.twitter.com/LOURDESsanz11.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Nov 28, pp. 108920. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1016/j.surg.2024.10.011
Abstrakt: Background: The secondary consequences of surgical site occurrences, especially surgical site infections, worsen the patient's outcomes while significantly increasing health care costs. The implementation of preventive measures to reduce this complication rate should be one of the priorities to improve health care.
Methods: A randomized, open-label clinical trial was conducted between March 2019 and March 2021 in a general surgery department. Individuals who had undergone laparotomy and had risk factors for developing surgical site infections and surgical site occurrences were included and randomized to use either negative-pressure wound therapy or conventional dressing (control group) on the closed surgical incision. The aim of our study was to evaluate the benefit of negative-pressure wound therapy in the surgical site infection rates and other surgical site occurrences in both groups at a 30-day follow-up.
Results: Two hundred seventy-five participants were recruited and were analyzed, 147 (53.5%) in the negative-pressure wound therapy group and 128 (46.5%) in the control group. Thirty-one (11.3%) surgical site infections and 71 (25.8%) other surgical site occurrences were observed, being significantly lower in the negative-pressure wound therapy group (odds ratio 0.31, 95% confidence interval 0.14-0.71; P = .005) and (odds ratio 0.51, 95% confidence interval 0.29-0.90; P = .02), respectively. Absolute risk reduction was 13% for surgical site infection and 12% for other surgical site occurrences. Number needed to treat 9 (95% confidence interval 5-29) for surgical site infection and number needed to treat of 8 (95% confidence interval 5-51) for other surgical site occurrences. Median hospital stay was 3 days lower in the negative-pressure wound therapy group than in the control group (9 vs 12 days; P = .03). No severe adverse events attributable to the negative-pressure wound therapy dressing were reported.
Conclusion: Negative-pressure wound therapy decreases the risk of surgical site occurrences and surgical site infection after laparotomy, so that its use should be considered in patients with risk factors.
Competing Interests: Conflict of Interest/Disclosure There was no conflict of interest during the conduct of the study. Maria Moreno Gijón currently receives fees from Smith & Nephew for giving informative talks on the use of negative-pressure therapy in prophylaxis.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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