Negative pressure wound therapy in the prevention of wound infection in high risk abdominal wound closures

BACKGROUND: Wound infections continue to be an issue in abdominal surgery. Tissue perfusion may be a contributing factor. Negative pressure application may have promise in decreasing wound complication. METHOD: A retrospective review of prospectively collected data in patients with high-risk abdominal wounds was undertaken. Comorbidities, risk factors for infection, wound classification, and wound outcomes were all evaluated. The primary outcome measure was wound infection rate. Secondary outcomes included device safety and overall surgical site complication rate. RESULTS: Thirty patients were identified who had skin flaps in whom negative pressure was used. Negative pressure was applied for an average of 5.6 days (range, 5-7 days). No patient developed ischemia or necrosis of the skin flaps. No wound infections were identified. The overall wound complication rate was 3%. The comparable historical control wound complication rate was 20%, and chi(2) analysis showed a statistically significant decrease in the infection rate with negative-pressure wound therapy (P < .05). CONCLUSIONS: Negative-pressure wound therapy applied to a closed, high-risk surgical wound is safe, with no evidence of skin necrosis and decreased wound infection rate. (C) 2012 Published by Elsevier Inc.