Surgical Wound Infection Prevention using Topical Negative Pressure Therapy on Closed Abdominal Incisions - The "SWIPE IT" Randomised Clinical Trial.

Di Re, Angelina Marina, Wright, Danette, Tatt Toh, James Wei, El-Khoury, Toufic, Pathma-Nathan, Nimalan, Gosselink, Martijn Pieter, Khanijaun, Sukhwant, Raman, Sudarsanam and Ctercteko, Grahame (2021) Surgical Wound Infection Prevention using Topical Negative Pressure Therapy on Closed Abdominal Incisions - The "SWIPE IT" Randomised Clinical Trial. The Journal of hospital infection. ISSN 1532-2939.

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Abstract

BACKGROUND

Surgical site infections (SSIs) are the most common cause of health care-associated infections in surgical patients. It is unclear if incisional negative pressure wound therapy (NPWT) can reduce the risk of SSIs in patients after open abdominal surgery.

METHODS

A prospective, non-blinded multi-centre randomised controlled trial (RCT) was performed to evaluate the incidence of SSI post-laparotomy using incisional NPWT compared to a standard dressing. The primary outcome was the rate of superficial SSI.

RESULTS

There were 124 patients (61 patients in the NPWT arm and 63 patients in the control arm) included. One hundred and nine (87.9%) patients underwent colorectal surgery; 61 patients (49.2%) had emergency surgery. There were more superficial SSIs in the control group than the NPWT group, although not statistically significance (20.6% versus 9.8%, p=0.1). Upon multiple logistic regression analysis, control dressings were associated with increased risk of superficial SSI although again, not statistically significant (OR 2.41, 95%CI 0.81-7.17, p=0.11). There was no superficial non-SSI related wound dehiscence in the NPWT group compared to 9.5% in the control group (p=0.03). There was no difference in post-operative complications (p=0.15), nor other wound complications (p=0.79).

CONCLUSION

NPWT was not associated with decreased superficial SSI in this RCT. However, there was a statistically significant reduction in superficial wound dehiscence with NWPT dressings. The results of this study should be included in meta-analyses for better evaluation of NPWT on closed abdominal incisions.

Item Type: Article
Subjects: QA Mathematics. Computing
WO Surgery
Divisions: Clinical Support > Infection Control
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 08 Feb 2021 14:00
Last Modified: 08 Feb 2021 14:00
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3958

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