Wound healing complications (WHCs) in the groin after vascular surgeries are a serious problem for patients and surgeons in various surgical disciplines. The incidence of WHCs of up to 44% after incisions in the groin is often responsible for prolonged hospital stay and high treatment costs. An effective reduction of WHCs for various wound types after using closed incision negative pressure therapy (ciNPT) has been documented in many case reports and clinical studies. As the majority of studies have addressed the effect of ciNPT on primary groin incision wounds, concerning groin incision wounds after revision vascular surgery are extremely scarce. The aim of this prospective, randomized clinical study was to investigate the effectiveness of ciNPT compared with conventional therapy on groin incisions after revision vascular surgery. We analyzed the cases of a total of 94 patients with 100 groin incisions. Patients were randomized and treated with either PREVENA™ (n=47 groins) or a conventional adhesive dressing (n=53 groins; control group). PREVENA™ was applied intraoperatively and was removed on day 5, 6 or 7 postoperatively. Wound evaluation was carried out on the 5th to 7th and 30th postoperative day. Compared with the control group, the ciNPT group showed a reduction in the overall incidence of WHCs assessed 30 days postoperatively (p<0.0005). With regard to prevention of revision surgeries, the ciNPT had no significant impact (p=0.056). Subgroup analysis revealed a significant effect of ciNPT for almost all wound healing risk factors. Based on our results, ciNPT provides a promising therapeutic option to reduce the frequency of postoperative WHCs and the need for revision surgeries in the groin after revision vascular surgery in patients with wound healing risk factors.
| Published in | Journal of Surgery (Volume 9, Issue 1) |
| DOI | 10.11648/j.js.20210901.17 |
| Page(s) | 36-44 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Closed Incision Negative Pressure Therapy, Surgical Site Infections, Postoperative Wound Complications, Wound Healing
| [1] | National Healthcare Safety Network (HSN) 2019 Surgical Site Infection (SSI) Protocol: https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. |
| [2] | Magill, SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, et al. Multistate point-prevalence survey of health care-associated infections. New England Journal of Medicine. 2014; 370 (13): 1198-1208. |
| [3] | de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, et al. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009; 37 (5): 387-97. |
| [4] | Condon, R. E., Schulte WJ, Malangoni MA, Anderson-Teschendorf MJ. Effectiveness of a surgical wound surveillance program. Archives of Surgery. 1983; 118 (3): 303-7. |
| [5] | Matatov T, Reddy KN, Doucet LD, Zhao CX, Zhang WW. Experience with a new negative pressure incision management system in prevention of groin wound infection in vascular surgery patients. J Vasc Surg. 2013; 57 (3): 791-5. |
| [6] | Pleger SP, Nink N, Elzien M, Kunold A, Koshty A, et al. Reduction of groin wound complications in vascular surgery patients using closed incision negative pressure therapy (ciNPT): a prospective, randomised, single-institution study. Int Wound J. 2018; 15 (1): 75-83. |
| [7] | Gombert A, Babilon M, Barbati ME, Keszei A, von Trotha KT, et al. Closed Incision Negative Pressure Therapy Reduces Surgical Site Infections in Vascular Surgery: A Prospective Randomised Trial (AIMS Trial). Eur J Vasc Endovasc Surg. 2018; 56 (3): 442-8. |
| [8] | Sabat J, Tyagi S, Srouji A, Pechman D, Gupta AM, et al. Prophylactic negative pressure therapy for femoral incision in vascular surgery: preliminary results of a prospective randomised trial. Journal of Vascular Surgery. 2016; 63: 94S. |
| [9] | Gombert A, Dillavou E, D´Agostino R, Griffin L, Robertson JM, et al. A systematic review and meta-analysis of randomized controlled trials for the reduction of surgical site infection in closed incision management versus standard of care dressings over closed vascular groin incisions. Vascular. 2020; 28 (3): 274-84. |
| [10] | Svensson-Björk R, Zarrouk M, Asciutto G, Hasselmann J, Acosta S, et al. Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery, BJS. 2019; 106 (4): 310-8. |
| [11] | Dosluoglu HH, Loghmanee C, Lall P, Cherr GS, Harris LM, et al. Management of early (<30 day) vascular groin infections using vacuum-assisted closure alone without muscle flap coverage in a consecutive patient series. J Vasc Surg. 2010; 51: 1160-6. |
| [12] | Stannard JP, Robinson JT, Anderson ER, McGwin G, Volgas DA, et al. Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma. J Trauma. 2006; 60: 1301-6. |
| [13] | Gustafsson R, Johnsson P, Algotsson L, Blomquist S, Ingemansson R. Vacuum-assisted closure therapy guided by C-reactive protein level in patients with deep sternal wound infection. J Thorac Cardiovasc Surg. 2002; 123: 895-900. |
| [14] | Wongworawat MD, Schnall SB, Holtom PD, Moon C, Schiller F. Negative pressure dressings as an alternative technique for the treatment of infected wounds. Clin Orthop. 2003; 414: 45-8. |
| [15] | DeFranzo AJ, Argenta LC, Marks MW, Molnar JA, David LR, et al. The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg. 2001; 108: 1184-91. |
| [16] | Hasselmann J, Björk J, Svensson-Björk R, Acosta S. Inguinal Vascular Surgical Wound Protection by Incisional Negative Pressure Wound Therapy: A Randomized Controlled Trial-INVIPS Trial. Ann Surg. 2020; 271 (1): 48-53. |
| [17] | Grauhan O, Navasardyan A, Tutkun B, Hennig F, Müller P, et al. Effect of surgical incision management on wound infections in a poststernotomy patient population. Int Wound J. 2014; 11 Suppl 1: 6-9. |
| [18] | Pachowsky M, Gusinde J, Klein A, Lehrl S, Schulz-Drost S. Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Int Orthop. 2012; 36 (4): 719-22. |
| [19] | Conde-Green A, Chung TL, Holton LH, Hui-Chou HG, Zhu Y, et al. Incisional Negative-Pressure Wound Therapy versus conventional dressings following abdominal wall reconstruction. A comparative study. Ann Plast Surg. 2013; 71 (4): 394-7. |
| [20] | Stannard JP, Volgas DA, McGwin G, Stewart RL, Obremskey W, et al. Incisional negative pressure wound therapy after high-risk lower extremity fractures. J Orthop Trauma. 2012; 26 (1): 37-42 |
| [21] | Anglim B, Oconnor H, Daly S. PrevenaTM negative pressure wound therapy applied to closed Pfannenstiel incisions at time of caesarean section in patients deemed at high risk for wound infection. J Obstet Gynaecol. 2015; 35 (3): 255-8. |
| [22] | Galiano RD, Hudson D, Shin J, van der Hulst R, Tanaydin V, et al. Incisional Negative Pressure Wound Therapy for Prevention of Wound Healing Complications Following Reduction Mammaplasty. Plast Reconstr Surg Glob Open. 2018; 6 (1): e1560. |
| [23] | Fowler AL, Barry MK. Closed incision negative pressure therapy for laparotomy wounds: A review. Clin Surg. 2018; 3: 2123. |
| [24] | Horch RE. Incisional negative pressure wound therapy for high-risk wounds. J Wound Care 2015; 24: 21-8. |
| [25] | Koetje JH, Ottink KD, Feenstra I, Fritschy WM. Negative Pressure Incision Management System in the Prevention of Groin Wound Infection in Vascular Surgery Patients. Surgery Research and Practice. 2015; 2015: 303560. |
| [26] | Engelhardt M, Rashad NA, Wily C, Müller C, Bauer C, et al. Closed-incision negative pressure therapy to reduce groin wound infections in vascular surgery: a randomised controlled trial. Int Wound J. 2018; 15 (3): 327-32. |
| [27] | Lee K, Murphy PB, Ingves MV, Duncan A, DeRose G, et al. Randomized clinical trial of negative pressure wound therapy for high-risk groin wounds in lower extremity revascularization. J Vasc Surg. 2017; 66 (6): 1814-9. |
| [28] | Kwon J, Staley C, McCullough M, Goss S, Arosemena M, et al. A randomized clinical trial evaluating negative pressure therapy to decrease vascular groin incision complications. J Vasc Surg. 2018; 68 (6): 1744-52. |
| [29] | Singh DP, Gabriel A, Silverman RP, Griffin LP, D´Agostino McGowan L, et al. Meta-analysis Comparing Outcomes of Two Different Negative Pressure Therapy Systems in Closed Incision Management. Plast Reconstr Surg Glob Open. 2019; 21; 7 (6): e2259. |
| [30] | Szilagyi DE, Smith RF, Elliott JP, Vrandecic MP. Infection in arterial reconstruction with synthetic grafts. Ann Surg. 1972; 176: 321-33. |
APA Style
Sebastian Paul Pleger, Liesa Fuhrmann, Mouiad Al Tattan, Alexander Kunold, Meshal Elzien, et al. (2021). Closed Incision Negative Pressure Therapy for Management of Incision Wounds in the Groin After Revision Vascular Surgery: A Randomized Controlled Trial. Journal of Surgery, 9(1), 36-44. https://doi.org/10.11648/j.js.20210901.17
ACS Style
Sebastian Paul Pleger; Liesa Fuhrmann; Mouiad Al Tattan; Alexander Kunold; Meshal Elzien, et al. Closed Incision Negative Pressure Therapy for Management of Incision Wounds in the Groin After Revision Vascular Surgery: A Randomized Controlled Trial. J. Surg. 2021, 9(1), 36-44. doi: 10.11648/j.js.20210901.17
AMA Style
Sebastian Paul Pleger, Liesa Fuhrmann, Mouiad Al Tattan, Alexander Kunold, Meshal Elzien, et al. Closed Incision Negative Pressure Therapy for Management of Incision Wounds in the Groin After Revision Vascular Surgery: A Randomized Controlled Trial. J Surg. 2021;9(1):36-44. doi: 10.11648/j.js.20210901.17
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Download@article{10.11648/j.js.20210901.17,
author = {Sebastian Paul Pleger and Liesa Fuhrmann and Mouiad Al Tattan and Alexander Kunold and Meshal Elzien and Andreas Böning and Ahmed Koshty},
title = {Closed Incision Negative Pressure Therapy for Management of Incision Wounds in the Groin After Revision Vascular Surgery: A Randomized Controlled Trial},
journal = {Journal of Surgery},
volume = {9},
number = {1},
pages = {36-44},
doi = {10.11648/j.js.20210901.17},
url = {https://doi.org/10.11648/j.js.20210901.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210901.17},
abstract = {Wound healing complications (WHCs) in the groin after vascular surgeries are a serious problem for patients and surgeons in various surgical disciplines. The incidence of WHCs of up to 44% after incisions in the groin is often responsible for prolonged hospital stay and high treatment costs. An effective reduction of WHCs for various wound types after using closed incision negative pressure therapy (ciNPT) has been documented in many case reports and clinical studies. As the majority of studies have addressed the effect of ciNPT on primary groin incision wounds, concerning groin incision wounds after revision vascular surgery are extremely scarce. The aim of this prospective, randomized clinical study was to investigate the effectiveness of ciNPT compared with conventional therapy on groin incisions after revision vascular surgery. We analyzed the cases of a total of 94 patients with 100 groin incisions. Patients were randomized and treated with either PREVENA™ (n=47 groins) or a conventional adhesive dressing (n=53 groins; control group). PREVENA™ was applied intraoperatively and was removed on day 5, 6 or 7 postoperatively. Wound evaluation was carried out on the 5th to 7th and 30th postoperative day. Compared with the control group, the ciNPT group showed a reduction in the overall incidence of WHCs assessed 30 days postoperatively (p<0.0005). With regard to prevention of revision surgeries, the ciNPT had no significant impact (p=0.056). Subgroup analysis revealed a significant effect of ciNPT for almost all wound healing risk factors. Based on our results, ciNPT provides a promising therapeutic option to reduce the frequency of postoperative WHCs and the need for revision surgeries in the groin after revision vascular surgery in patients with wound healing risk factors.},
year = {2021}
}
TY - JOUR T1 - Closed Incision Negative Pressure Therapy for Management of Incision Wounds in the Groin After Revision Vascular Surgery: A Randomized Controlled Trial AU - Sebastian Paul Pleger AU - Liesa Fuhrmann AU - Mouiad Al Tattan AU - Alexander Kunold AU - Meshal Elzien AU - Andreas Böning AU - Ahmed Koshty Y1 - 2021/02/27 PY - 2021 N1 - https://doi.org/10.11648/j.js.20210901.17 DO - 10.11648/j.js.20210901.17 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 36 EP - 44 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20210901.17 AB - Wound healing complications (WHCs) in the groin after vascular surgeries are a serious problem for patients and surgeons in various surgical disciplines. The incidence of WHCs of up to 44% after incisions in the groin is often responsible for prolonged hospital stay and high treatment costs. An effective reduction of WHCs for various wound types after using closed incision negative pressure therapy (ciNPT) has been documented in many case reports and clinical studies. As the majority of studies have addressed the effect of ciNPT on primary groin incision wounds, concerning groin incision wounds after revision vascular surgery are extremely scarce. The aim of this prospective, randomized clinical study was to investigate the effectiveness of ciNPT compared with conventional therapy on groin incisions after revision vascular surgery. We analyzed the cases of a total of 94 patients with 100 groin incisions. Patients were randomized and treated with either PREVENA™ (n=47 groins) or a conventional adhesive dressing (n=53 groins; control group). PREVENA™ was applied intraoperatively and was removed on day 5, 6 or 7 postoperatively. Wound evaluation was carried out on the 5th to 7th and 30th postoperative day. Compared with the control group, the ciNPT group showed a reduction in the overall incidence of WHCs assessed 30 days postoperatively (p<0.0005). With regard to prevention of revision surgeries, the ciNPT had no significant impact (p=0.056). Subgroup analysis revealed a significant effect of ciNPT for almost all wound healing risk factors. Based on our results, ciNPT provides a promising therapeutic option to reduce the frequency of postoperative WHCs and the need for revision surgeries in the groin after revision vascular surgery in patients with wound healing risk factors. VL - 9 IS - 1 ER -
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