Surgical wound infection prevention using topical negative pressure therapy on closed abdominal incisions – the ‘SWIPE IT’ randomized clinical trial
| Autor: | James Wei Tatt Toh, S. Raman, A.M. Di Re, Toufic El-Khoury, S. Khanijaun, Danette Bianca Wright, Nimalan Pathma-Nathan, Martijn P. Gosselink, Grahame Ctercteko |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty medicine.medical_treatment 030501 epidemiology law.invention 03 medical and health sciences Randomized controlled trial law Negative-pressure wound therapy Abdomen medicine Humans Surgical Wound Infection Laparotomy 0303 health sciences 030306 microbiology Wound dehiscence business.industry Incidence Surgical wound General Medicine Odds ratio medicine.disease Bandages Colorectal surgery Surgery Infectious Diseases 0305 other medical science business Trauma surgery Negative-Pressure Wound Therapy Abdominal surgery |
| Zdroj: | Journal of Hospital Infection. 110:76-83 |
| ISSN: | 0195-6701 |
| DOI: | 10.1016/j.jhin.2021.01.013 |
| Popis: | Summary Background Surgical site infections (SSIs) are the most common cause of healthcare-associated infections in surgical patients. It is unclear whether incisional negative pressure wound therapy (NPWT) can reduce the risk of SSIs in patients after open abdominal surgery. Methods A prospective, non-blinded multi-centre randomized controlled trial (RCT) was performed to evaluate the incidence of SSI post-laparotomy using incisional NPWT compared with a standard dressing. The primary outcome was the rate of superficial SSI. Results A total of 124 patients (61 patients in the NPWT arm and 63 patients in the control arm) were included. One hundred and nine (87.9%) patients underwent colorectal surgery; 61 patients (49.2%) had emergency surgery. There were more superficial SSIs in the control group than in the NPWT group, although not statistically significant (20.6% vs 9.8%, P=0.1). Upon multiple logistic regression analysis, control dressings were associated with increased risk of superficial SSI although again, not statistically significant (odds ratio (OR) 2.41, 95% confidence interval (CI) 0.81–7.17, P=0.11). There was no superficial non-SSI related wound dehiscence in the NPWT group compared with 9.5% in the control group (P=0.03). There was no difference in postoperative complications (P=0.15), nor in other wound complications (P=0.79). Conclusion NPWT was not associated with decreased superficial SSI in this RCT. However, there was a statistically significant reduction in superficial wound dehiscence with NWPT dressings. The results of this study should be included in meta-analyses for better evaluation of NPWT on closed abdominal incisions. |
| Databáze: | OpenAIRE |
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