Incisional Negative Pressure Wound Therapy Significantly Reduces Surgical Site Infection in Open Colorectal Surgery

BACKGROUND: Surgical site infections in colorectal surgery remain a common problem, and are associated with an increase in cost of care and length of stay. OBJECTIVE: This study aims to evaluate the effect of known risk factors and the use of incisional negative pressure wound therapy on surgical site infection rates. DESIGN: This is a single-center retrospective study with the use of chart review. SETTINGS: The study took place at a tertiary academic medical center. PATIENTS: All patients undergoing open colectomy at a single institution from 2009 through 2011 were studied. MAIN OUTCOME MEASURES: The primary outcome measured was the presence or absence of surgical site infection. RESULTS: Overall, 69 of the 254 patients (27.2%) experienced surgical site infection; 4 (12.5%) surgical site infections were seen in patients undergoing incisional negative pressure wound therapy and 65 (29.3%) were seen in patients undergoing standard closure. Multiple logistic regression revealed 2 significant factors: diabetes mellitus increased the chance of surgical site infection (OR, 1.98; p < 0.05), and the use of incisional negative pressure wound therapy decreased the chance of surgical site infection (OR, 0.32; p < 0.05). Obesity was associated with a trend toward increasing surgical site infection (OR, 1.64; p = 0.10). LIMITATIONS: This study is limited by its retrospective nature and the high baseline prevalence of surgical site infection. CONCLUSIONS: Incisional negative pressure wound therapy appears to reduce surgical site infection in open colorectal surgery. Further study may be helpful to identify patient populations who would have the greatest benefit from this technique (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A115).