Reduction of groin wound complications in vascular surgery patients using closed incision negative pressure therapy (ciNPT): a prospective, randomised, single-institution study

Sebastian P Pleger, Nadine Nink, Meshal Elzien, Alexander Kunold, Ahmed Koshty, Andreas Böning, Sebastian P Pleger, Nadine Nink, Meshal Elzien, Alexander Kunold, Ahmed Koshty, Andreas Böning

Abstract

Groin wound infections in patients undergoing vascular procedures often cause a lengthy process of wound healing. Several clinical studies and case reports show a reduction of surgical site infections (SSIs) in various wound types after using closed incision negative pressure therapy (ciNPT). The aim of this prospective, randomised, single-institution study was to investigate the effectiveness of ciNPT (PREVENA™ Therapy) compared to conventional therapy on groin incisions after vascular surgery. From 1 February to 30 October 2015, 100 patients with 129 groin incisions were analysed. Patients were randomised and treated with either ciNPT (n = 58 groins) or the control dressing (n = 71 groins). ciNPT was applied intraoperatively and removed on days 5-7 postoperatively. The control group received a conventional adhesive plaster. Wound evaluation based on the Szilagyi classification took place postoperatively on days 5-7 and 30. Compared to the control group, the ciNPT group showed a significant reduction in wound complications (P < 0·0005) after both wound evaluation periods and in revision surgeries (P = 0·022) until 30 days postoperatively. Subgroup analysis revealed that ciNPT had a significant effect on almost all examined risk factors for wound healing. ciNPT significantly reduced the incidence of incision complications and revision procedures after vascular surgery.

Keywords: closed incision negative pressure therapy; surgical site infections; vascular surgery; wound healing.

© 2017 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
(A) Components of ciNPT; B) ciNPT after aortobifemoral bypass.
Figure 2
Figure 2
Wound complications of study patients based on Szilagyi classification. (A) Szilagyi I: Skin necrosis, superficial wound dehiscence and local infection; (B) Szilagyi II: Deep wound dehiscence and fat necrosis; (C) Szilagyi III: Prosthetic graft infection.
Figure 3
Figure 3
Wound results after removing ciNPT on (A) 5–7 days and (B) 30 days postoperatively.
Figure 4
Figure 4
ROC curve of (A) all perioperative risk factors, (B) perioperative risk factor operation time and (C) perioperative risk factor wound length.

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