Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal

IF 1.7 Q3 SURGERY

Surgery open science Pub Date : 2025-01-01 DOI:10.1016/j.sopen.2025.01.002

Brian Williams MD , Aubrey Swinford MD , Jordan Martucci MD , Johnny Wang MD , Jordan R. Wlodarczyk MD , Abhinav Gupta MD , Kyle G. Cologne MD , Sarah E. Koller MD , Christine Hsieh MD , Marjun P. Duldulao MD , Joongho Shin MD

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引用次数: 0

Abstract

Background

The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods.

Methods

This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported.

Results

Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days.

Conclusion

Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.

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机械负压敷料减少造口术后手术部位感染

研究表明，闭合切口负压伤口治疗（ci-NPWT）可减少造口术后伤口并发症和手术部位感染（SSI）。然而，由于设备的高成本，这种方法的使用尚未被广泛采用。我们提出了一种新的方法，其中一个独立的机械动力负压敷料（MP-NPD）应用于主要关闭的造口逆转伤口。我们假设与传统的造口方法相比，SSI和伤口并发症发生率将得到改善。方法：这是一项前瞻性研究者发起的研究，在2021年5月至2022年3月期间，连续接受造口逆转和初级造口伤口闭合的患者使用MP-NPD。然后报告研究组30天的结果，包括手术部位感染、其他伤口并发症、住院时间（LOS）和再入院率。结果研究组有46例局部回肠造口或结肠造口闭合患者。报告了患者人口统计学和手术变量。研究队列中有1例（2.2%）患者在手术后30天内发生浅表SSI。研究组的术后生存期为4.1天。结论采用MP-NPD敷料进行肠造口逆转创面的初步闭合和敷料敷料敷料敷料敷料后，造口部位SSI发生率极低。这些结果是有希望的，因为它们与MP-NPD在气孔逆转手术中的应用有关，然而，进一步的大型前瞻性随机对照试验与匹配的对照组可以帮助更好地证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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