Prevention of surgical site infections in high-risk patients with laparotomy incisions using negative-pressure therapy

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• 作者：Aaron U. Blackham ; M.D.^a ; Jason P. Farrah ; M.D.^a ; Thomas P. McCoy ; M.S.^b ; Benjamin S. Schmidt ; M.D.^a ; Perry Shen ; M.D.^a ; ^{pshen@wakehealth.edu}
• 关键词：Negative-pressure therapy ; Surgical site infections ; Prevention ; Laparotomy ; Quality improvement
• 刊名：The American Journal of Surgery
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：205
• 期：6
• 页码：647-654
• 全文大小：904 K

文摘

Background

This study evaluates the efficacy of negative-pressure therapy (NPT) in preventing surgical site infections (SSIs) in high-risk surgical oncology patients.

Methods

A retrospective analysis of 191 operations for colorectal, pancreatic, or peritoneal surface malignancies was performed. Incisional NPT was used in patients with multiple SSI risk factors. Rates of SSIs were compared with patients treated with a standard sterile dressing (SSD).

Results

NPT was used in 104 patients, whereas SSDs were used in 87 patients. Despite being at an increased risk of SSI, patients treated with NPT developed fewer superficial incisional SSIs compared with SSD patients (6.7 % vs 19.5 % , P = .015). In a subgroup analysis of clean-contaminated cases, NPT was associated with fewer superficial incisional SSIs (6.0 % vs 27.4 % , P = .001), fewer total?SSIs (16.0 % vs 35.5 % , P = .011), and fewer wound openings for any reason (16.0 % vs 35.5 % , P = .011).

Conclusions

Our findings suggest that NPT decreases SSIs in high-risk surgical oncology patients.