Negative pressure wound therapy for emergency laparotomy incisions: A national database propensity matched study - 22/02/24
![](/templates/common/images/mail.png)
Abstract |
Background |
Surgical site infections (SSI) are a common complication of laparotomy incisions. The role of Negative Pressure Wound Therapy (NPWT) in preventing SSIs has not yet been explored in a nationwide analysis. We aimed to evaluate the association of the prophylactic use of NPWT with SSIs in patients undergoing an emergency laparotomy procedure.
Methods |
We conducted a retrospective cohort study using the National Surgery Quality Initiative Program (NSQIP) database from 2013 to 2020. We included patients ≥18 years undergoing an emergency laparotomy. We performed a 1:1 propensity matching adjusting for patient age, sex, race, ethnicity, BMI, comorbid conditions, ASA status, diagnosis, preoperative factors and laboratory variables, procedure type, wound class, and intraoperative variables. We compared NPWT with standard dressings in two patient populations: 1. patients with completely closed (skin and fascia) laparotomy incisions and 2. patients with partially closed (fascia only) laparotomy incisions. Our primary outcome was the rate of incisional SSI. Secondary outcomes included the type of SSI, postoperative 30-day complications, postoperative hospital length of stay, and discharge disposition.
Results |
We included 65,803 patients with completely closed incisions of whom 387 patients received NPWT. There was no significant difference in the rate of total SSIs (13.4 % vs. 11.9 %; p = 0.52) in the matched population of 387 pairs. We included 7285 patients with partially closed incisions of whom 477 patients received NPWT. There was no significant difference in the rate of total SSIs (3.6 % vs. 4.4 %; p = 0.51) in the matched population of 477 pairs. Secondary outcomes did not differ significantly in either group.
Conclusion |
The rate of SSIs was not significantly different when prophylactic NPWT was used compared to standard dressings for patients with a closed or partially closed laparotomy incision.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In patients with skin and fascial closure, use of NPWT was not associated with lower rates of surgical site infections. |
• | In patients with fascial closure only, use of NPWT was not associated with lower rates of surgical site infections. |
• | There was no difference in secondary outcomes in patients with laparotomy incisions receiving NPWT versus standard dressings. |
Keywords : Negative pressure wound therapy, NPWT, Emergency, Laparotomy
Plan
Vol 228
P. 287-294 - février 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?