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Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections in Closed Abdominal Incision- A Randomised Controlled Trial.

Advances in Wound Care 2023 August 31
OBJECTIVE: This study aimed to evaluate the efficacy of prophylactic negative pressure wound therapy (PNPWT) in reducing the incidence of surgical site infection (SSI), and other wound complications in closed abdominal incisions.

APPROACH: This was a prospective, single-center, open-label parallel arm superiority randomized controlled trial conducted over 2 years. Participants were randomly assigned to PNPWT and standard surgical dressing (SSD) group. The occurrence of postoperative SSI within 30 days, other wound related complications, length of hospital stay, and readmission within 1 month among both the study group were studied.

RESULTS: A total of 140 participants were included, with 70 each randomized to the PNPWT and SSD groups. In this study, 28.5% and 5.8% developed SSI in the SSD and PNPWT groups respectively (RR-0.26; 95%, CI-0.08-0.80; p=0.001). Similarly, the incidence of seroma (7.2% vs 18.5%, p=0.016), wound dehiscence (0 vs 4.2%, p=0.244), superficial & deep SSI (5.7% vs 24.3%, p=0.001) & (0 vs 4.2%, p=0.244) and length of hospital stay (days) (9 vs 10.5, p=0.07) were less in PNPWT compared to SSD group.

INNOVATION: Despite the advances in surgical care, SSI rates continues to be high. The present findings might facilitate the use of PNPWT as a novel preventive strategy to reduce SSI in closed abdominal incision.

CONCLUSION: The PNPWT in closed incisions following elective laparotomy can reduce the incidence of SSI when compared to SSD. The use of PNPWT was associated with a lower incidence of superficial SSI and seroma but without significant reduction in hospital stay.

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