The effect of negative pressure wound therapy on surgical site occurrences in closed incision abdominal wall reconstructions: a retrospective single surgeon and institution study

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 25; no. 6; pp. 1549 - 1555
• Main Authors: Seaman, A. P., Sarac, B. A., ElHawary, H., Janis, J. E.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.12.2021; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Abdominal wall; Abdominal Wall - surgery; Forum on Complexities in Hernia; Herniorrhaphy - adverse effects; Humans; Medicine; Medicine & Public Health; Negative-Pressure Wound Therapy - adverse effects; Original Article; Pressure ulcers; Retrospective Studies; Statistical analysis; Surgeons; Surgical Wound; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Surgical Wound Infection - prevention & control; Wound healing; Wounds; Closed incision negative pressure wound therapy
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-021-02427-3

Purpose The use of closed incision negative pressure wound therapy (ciNPWT) in abdominal wall reconstruction is heavily debated. The current literature shows mixed results for its efficacy in preventing surgical site occurrences (SSOs), and many of the studies are limited by small sample size or a lack of generalizability. We sought to assess whether the use of prophylactic ciNPWT has an effect on reducing the rate of SSOs. Methods Following institutional review board approval, a retrospective analysis of a prospectively collected abdominal wall reconstruction database of a single surgeon at a single institution was completed. Two hundred and seventy patients were reviewed. Univariate and multivariate logistic regressions were performed to assess the effect of each variable on the rate of SSOs. Results Two hundred and fifty-eight patients (95.56%) met inclusion criteria. One hundred and fifty-nine (61.63%) of these patients received ciNPWT. The median duration of ciNPWT was 6 days. Multivariate logistic regression analysis showed no significant difference in the prevalence of SSOs between groups (OR = 0.843, 95% CI [0.445–1.594], p  = 0.598). It did, however, show a significant decrease in the rates of seroma (7.07% vs. 0.63%, p  = 0.004). Moreover, skin resection was associated with a decreased rate of SSO (OR = 0.295, 95% CI [0.096–0.911], p  = 0.034). Conclusions ciNPWT was not associated with a decrease in SSOs following abdominal wall reconstruction but did show a statistically significant decrease in postoperative seromas. Future, large prospective analyses may help further discover the utility of ciNPWT in reducing SSOs.