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

被引:105
作者
Blackham, Aaron U. [1 ]
Farrah, Jason P. [1 ]
McCoy, Thomas P. [2 ]
Schmidt, Benjamin S. [1 ]
Shen, Perry [1 ]
机构
[1] Wake Forest Sch Med, Dept Gen Surg, Winston Salem, NC 27157 USA
[2] Wake Forest Sch Med, Dept Biostat Sci, Winston Salem, NC USA
关键词
Negative-pressure therapy; Surgical site infections; Prevention; Laparotomy; Quality improvement; VACUUM-ASSISTED CLOSURE; COLORECTAL SURGERY; BOWEL PREPARATION; WOUND INFECTIONS; RANDOMIZED-TRIAL; COLLAGEN SPONGE; FOLLOW-UP; PROPHYLAXIS; REDUCTION; GUIDELINE;
D O I
10.1016/j.amjsurg.2012.06.007
中图分类号
R61 [外科手术学];
学科分类号
摘要
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. (c) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:647 / 654
页数:8
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