Miles W Reese, Raymond L Hogge, Brendan J Roess, John M Hepner, Robert D Luke, Ricardo E Rendel, Ishraq K Kabir, Tuan M Nguyen, Kristen N Snyder, Julia A Heaton, Michael T Martyak
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The secondary outcome was development of superficial SSI in closed wounds. <b>Results:</b> 260 patients, 111 pre-iNPWT and 149 post-iNPWT implementation, were included. The proportion of patients who were discharged with an open wound in the pre-iNPWT group was 52.3% vs 18.8% in the post-iNPWT group, <i>P</i> = <.001. The proportion of patients with closed wounds who developed a superficial SSI in the pre-iNPWT group was 12.1%, 8 of 66, vs 5.9%, 8 of 135, in the post-iNPWT group, <i>P</i> = .13. The proportion of patients with closed class III wounds who developed a superficial SSI was 14.0%, 7 of 50, vs 5.0%, 6 of 119, in the post-iNPWT group, <i>P</i> = .046. <b>Conclusion:</b> Our study identified a decrease in the number of patients who were discharged with an open wound after the implementation of iNPWT without an increase in SSIs. A decrease in SSIs in class III wounds closed with iNPWT was also observed.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1123-1128"},"PeriodicalIF":0.9000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Implementation of Incisional Negative Pressure Therapy in Trauma Laparotomies Leads to Fewer Open Wounds at Discharge.\",\"authors\":\"Miles W Reese, Raymond L Hogge, Brendan J Roess, John M Hepner, Robert D Luke, Ricardo E Rendel, Ishraq K Kabir, Tuan M Nguyen, Kristen N Snyder, Julia A Heaton, Michael T Martyak\",\"doi\":\"10.1177/00031348251339700\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> Surgical site infections (SSIs) tend to be higher in emergent trauma cases. To combat this increased risk, the skin is often left open and allowed to heal by secondary intention. We sought to investigate the effect of the implementation of incisional negative pressure wound therapy (iNPWT) in trauma laparotomies. <b>Methods:</b> A single-institution retrospective chart review was performed of trauma patients receiving an emergent exploratory laparotomy between 2015 and 2022. Patients with class II and III wounds were included. The primary outcome was open wound at discharge between the pre-iNPWT and post-iNPWT implementation. The secondary outcome was development of superficial SSI in closed wounds. <b>Results:</b> 260 patients, 111 pre-iNPWT and 149 post-iNPWT implementation, were included. The proportion of patients who were discharged with an open wound in the pre-iNPWT group was 52.3% vs 18.8% in the post-iNPWT group, <i>P</i> = <.001. The proportion of patients with closed wounds who developed a superficial SSI in the pre-iNPWT group was 12.1%, 8 of 66, vs 5.9%, 8 of 135, in the post-iNPWT group, <i>P</i> = .13. The proportion of patients with closed class III wounds who developed a superficial SSI was 14.0%, 7 of 50, vs 5.0%, 6 of 119, in the post-iNPWT group, <i>P</i> = .046. <b>Conclusion:</b> Our study identified a decrease in the number of patients who were discharged with an open wound after the implementation of iNPWT without an increase in SSIs. 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引用次数: 0
摘要
背景:外科手术部位感染(ssi)在急诊创伤病例中往往更高。为了对抗这种增加的风险,通常会让皮肤保持开放状态,让其自行愈合。我们试图探讨创伤剖腹手术实施切口负压伤口治疗(iNPWT)的效果。方法:对2015年至2022年间接受急诊剖腹探查术的创伤患者进行单机构回顾性分析。包括II和III级伤口患者。主要结局是在inpwt实施前和inpwt实施后的出院时开放性伤口。次要结果是闭合伤口中浅表SSI的发展。结果:纳入260例患者,111例实施inpwt前,149例实施inpwt后。inpwt前组患者带开放性伤口出院的比例为52.3%,而inpwt后组为18.8%,P = P = 0.13。闭合性III类伤口患者发生浅表SSI的比例为14.0%,50人中有7人,而inpwt后组为5.0%,119人中有6人,P = 0.046。结论:我们的研究发现,实施iNPWT后开放性伤口出院的患者数量减少,而ssi没有增加。用iNPWT缝合的III类伤口也观察到ssi的减少。
The Implementation of Incisional Negative Pressure Therapy in Trauma Laparotomies Leads to Fewer Open Wounds at Discharge.
Background: Surgical site infections (SSIs) tend to be higher in emergent trauma cases. To combat this increased risk, the skin is often left open and allowed to heal by secondary intention. We sought to investigate the effect of the implementation of incisional negative pressure wound therapy (iNPWT) in trauma laparotomies. Methods: A single-institution retrospective chart review was performed of trauma patients receiving an emergent exploratory laparotomy between 2015 and 2022. Patients with class II and III wounds were included. The primary outcome was open wound at discharge between the pre-iNPWT and post-iNPWT implementation. The secondary outcome was development of superficial SSI in closed wounds. Results: 260 patients, 111 pre-iNPWT and 149 post-iNPWT implementation, were included. The proportion of patients who were discharged with an open wound in the pre-iNPWT group was 52.3% vs 18.8% in the post-iNPWT group, P = <.001. The proportion of patients with closed wounds who developed a superficial SSI in the pre-iNPWT group was 12.1%, 8 of 66, vs 5.9%, 8 of 135, in the post-iNPWT group, P = .13. The proportion of patients with closed class III wounds who developed a superficial SSI was 14.0%, 7 of 50, vs 5.0%, 6 of 119, in the post-iNPWT group, P = .046. Conclusion: Our study identified a decrease in the number of patients who were discharged with an open wound after the implementation of iNPWT without an increase in SSIs. A decrease in SSIs in class III wounds closed with iNPWT was also observed.
期刊介绍:
The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.