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01-12-2024 | Vacuum Therapy | Research

Comparison of surgical site infection (SSI) between negative pressure wound therapy (NPWT) assisted delayed primary closure and conventional delayed primary closure in grossly contaminated emergency abdominal surgeries: a randomized controlled trial

Authors: Pradeep Kumar Singh, Mahesh Kumar Sethi, Tushar Subhadarshan Mishra, Pankaj Kumar, S. Manwar Ali, Prakash Kumar Sasmal, Swastik Sourav Mishra

Published in: Langenbeck's Archives of Surgery | Issue 1/2024

Abstract

Purpose

NPWT has been tried in many surgical fields, including colorectal, thoracic, vascular, and non-healing wounds, for the prevention of SSI. However, its efficacy in the prevention of SSI-grade IV closed abdominal wounds is yet to be explored.

Methods

All patients with grade IV abdominal wounds were included in the study. They were randomized into the conventional arm and the VAC arm after confirming the diagnosis intra-operatively. The sheath was closed, and the skin was laid open in the postoperative period. In the VAC arm, the NPWT dressing was applied on postoperative day (POD)-1 and removed on POD-5. In the conventional arm, only regular dressing was done postoperatively. The skin was closed with a delayed primary intention on POD-5 in both arms. The sutures were removed after 7 to 10 days of skin closure.

Results

The rate of SSI (10% in the VAC arm vs. 37.5% in the conventional arm, p-value = 0.004) was significantly lower in the VAC arm, as were the rates of seroma formation (2.4% in the VAC arm vs. 20% in the conventional arm, p = 0.014) and wound dehiscence (7.3% vs. 30%, p = 0.011). The conventional arm had a significant delay in skin closure beyond POD5 due to an increased rate of SSI, which also led to a prolonged hospital stay (5 days in the VAC arm vs. 6.5 days in the conventional arm, p-value = 0.005).

Conclusion

The VAC dressing can be used routinely in grade IV closed abdominal wounds to reduce the risk of SSI and wound dehiscence.

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Title: Comparison of surgical site infection (SSI) between negative pressure wound therapy (NPWT) assisted delayed primary closure and conventional delayed primary closure in grossly contaminated emergency abdominal surgeries: a randomized controlled trial
Authors: Pradeep Kumar Singh
Mahesh Kumar Sethi
Tushar Subhadarshan Mishra
Pankaj Kumar
S. Manwar Ali
Prakash Kumar Sasmal
Swastik Sourav Mishra
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Vacuum Therapy
Vacuum Therapy
Vacuum Therapy
Wound Dehiscence
Seroma
Abdominal Surgery
Published in: Langenbeck's Archives of Surgery / Issue 1/2024
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03202-x

2024 ASCO Annual Meeting

Springer Medicine

Comparison of surgical site infection (SSI) between negative pressure wound therapy (NPWT) assisted delayed primary closure and conventional delayed primary closure in grossly contaminated emergency abdominal surgeries: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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