Closed Incision Negative Pressure Therapy for Laparotomy Wounds: A Review

Fowler AL and Barry MK

Department of Surgery, National University of Ireland, Ireland

^*Correspondance to: Fowler AL 

 PDF  Full Text DOI: 10.25107/2474-1647.2123

Abstract

Background: Open abdominal surgery is associated with high rates of wound complications. Surgical site infection (SSI) carries a significant burden to the healthcare system and the patient and is associated with prolonged length of stay, delayed treatment and high rates of readmission. Negative pressure wound therapy over closed incisions (ciNPWT) is a novel approach to prevention of SSI. We reviewed the outcomes of studies comparing ciNPWT and standard therapy on laparotomy wounds to assess the efficacy of the current evidence base.Aim: To assess the effect of negative pressure wound therapy used over closed incisions in open abdominal surgery.
Methods: Search of relevant terms was conducted on PubMed and Google Scholar to identify relevant studies published between Jan 2006 - Dec 2017. Studies were chosen based on specific inclusion and exclusion criteria. An additional search was conducted to identify epidemiology, risk factors and cost-burden of SSI. Articles were screened to assess demographics, study design and outcomes.Results: Five retrospective and four prospective randomised controlled trials were identified for inclusion, totalling 1470 participants. 454 received ciNPWT and 1016 received standard treatment. Studies assessed a mix of surgeries (4=colorectal, 1=pancreaticoduodenectomy, 1=gynaecologic, 2=mixed). ciNPWT was statistically significant in reducing SSI in 8 of 9 studies (p<0.05).Conclusion: ciNPWT is a promising therapy for reducing the rate of SSI in open abdominal surgery however; its effect on other wound complications is unclear. Further multicenter, prospective studies are needed to assess cost-benefit, appropriate patient-selection and assess efficacy of closed incision negative pressure therapy in open abdominal surgery.

Keywords

Negative pressure wound therapy; Laparotomy; Open abdominal surgery; Surgical site infection; Complication

Cite the article

Fowler AL, Barry MK. Closed Incision Negative Pressure Therapy for Laparotomy Wounds: A Review. Clin Surg. 2018; 3: 2123.