دورية أكاديمية
أعرض في EDS

Closed incision prophylactic negative pressure wound therapy in patients undergoing major complex abdominal wall repair.

التفاصيل البيبلوغرافية
العنوان: Closed incision prophylactic negative pressure wound therapy in patients undergoing major complex abdominal wall repair.
المؤلفون: de Vries FEE; Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. f.e.devries@amc.uva.nl., Atema JJ; Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.; Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Lapid O; Department of Plastic and Reconstructive Surgery, Academic Medical Centre, Amsterdam, The Netherlands., Obdeijn MC; Department of Plastic and Reconstructive Surgery, Academic Medical Centre, Amsterdam, The Netherlands., Boermeester MA; Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
المصدر: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2017 Aug; Vol. 21 (4), pp. 583-589. Date of Electronic Publication: 2017 May 23.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Paris, France : Springer, c1997-
مواضيع طبية MeSH: Abdominal Wall/*surgery , Negative-Pressure Wound Therapy/*statistics & numerical data , Surgical Wound Infection/*prevention & control, Aged ; Elective Surgical Procedures/adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Netherlands/epidemiology ; Retrospective Studies ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Treatment Outcome
مستخلص: Purpose: To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair.
Methods: Retrospective before-after comparison nested in a consecutive series of patients undergoing elective major complex abdominal wall repair. Starting January 2014, pNPWT was applied on the closed incisional wound for a minimum of 5 days. To minimize selection bias, we compared two periods of 14 months before and after January 2014. Wound infections according to the Centre for Disease Control Surgical Site Infection classification as well as other wound complications were recorded.
Results: Thirty-two patients were included in the pNPWT group and 34 in the control group. The study group involved clean-contaminated and contaminated operations due to enterocutaneous fistula, enterostomies or infected mesh. Median duration of pNPWT was 5 days (IQR 5-7). Overall wound infection rate was 35%. pNPWT was associated with a significant decrease in postoperative wound infection rate (24 versus 51%; p = 0.029, OR 0.30 (95% CI 0.10-0.90)). Incisional wound infection rates dropped from 48 to 7% (p < 0.01, OR 0.08 (95% CI 0.16-0.39), whereas the number of subcutaneous abscesses was comparable in both groups. Moreover, less interventions were needed in the pNPWT group (p < 0.001).
Conclusions: Closed incision pNPWT seems a promising solution to reduce the incidence of wound infections in complex abdominal wall surgery. Randomized controlled trials are needed to estimate more precisely the value and cost-effectiveness of pNPWT in this high-risk setting.
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فهرسة مساهمة: Keywords: Complex abdominal wall repair; Prophylactic negative pressure
تواريخ الأحداث: Date Created: 20170524 Date Completed: 20180309 Latest Revision: 20181202
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5517612
DOI: 10.1007/s10029-017-1620-0
PMID: 28534258
قاعدة البيانات: MEDLINE
الوصف
تدمد:1248-9204
DOI:10.1007/s10029-017-1620-0