Trends in Clinical and Medical Sciences
Special issue: Indian Medical Research Views and Findings on Last 5 years (2023), pp. 262 – 269
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv041
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv041
A randomized control study to determine risk of surgical site infection after prophylactic negative pressure wound therapy for closed surgical incisions in a tertiary care centre of central India
Dr. Sunil Kumawat\(^{1,*}\), Dr. Sonia Moses\(^{2}\), Dr. Sachin Verma\(^{3}\), Dr. Shashi Shankar Sharma\(^{3}\) and Dr. Avinash Gautam\(^{4}\)
\(^{1}\) Postgraduate Resident, Department Of General Surgery, M.G.M Medical College & M.Y Hospital, Indore.
\(^{2}\) Professor, Department Of General Surgery, M.G.M Medical College & M.Y Hospital, Indore.
\(^{3}\) Associate Professor, Department Of General Surgery, M.G.M Medical College & M.Y Hospital, Indore.
\(^{4}\) Assistant Professor, Department Of General Surgery, M.G.M Medical College & M.Y Hospital, Indore.
Correspondence should be addressed to Dr. Sunil Kumawat at sunilgmc131993@gmail.com
Copyright © 2023 Dr. Sunil Kumawat, Dr. Sonia Moses, Dr. Sachin Verma, Dr. Shashi Shankar Sharma and Dr. Avinash Gautam. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: February 2, 2023 – Accepted: May 5, 2023 – Published: May 26, 2023
Abstract
Background and Aim: Surgical site infections (SSIs) are common after laparotomy wounds and are associated with a significant economic burden. The use of negative pressure wound therapy (NPWT) has recently been broadened to closed surgical incisions.
Material and Methods: The Institutional Ethics Committee approved this single-center, parallel, randomised controlled trial, which followed the Declaration of Helsinki. If they were 18–65 year old , patients were eligible. All surgery patients undergoing abdominal surgery and closed abdominal surgical wounds who received negative pressure wound therapy or conventional therapy. Exclusion criteria included abdominal pathology re-explored or re-operated and inability to consent. Trial participants received an information leaflet and gave written consent.
Result: The primary objective to assess the relative risk of development of SSI in the ciNPWT, the relative risk of development SSI in CiNPWT group was found to be 0.69 and 1.44 in group with conventional dressing, thus CiNPWT was found to be protective for SSI in incisional wound. CiNPWT and conventional patients were mostly 31-60 years old. 84 patients (70%) were male, while 36 (30%) were female in the study cohort.NPWT reduced wound complications like soakage and dehiscence by 20% on the 14th day after surgery. A 0.013 p-value indicated statistical significance. NPWT reduced wound complications like soakage and dehiscence on the 21st day after surgery. The 18.33% reduction was statistically significant at 0.0134. Negative Pressure Wound Therapy (NPWT) reduced soakage and dehiscence by 10% in serial follow-ups on the 30th day post-surgery. The study revealed a negative correlation between the levels of Total Serum Protein and Serum Albumin and both wound healing duration and duration of hospital stay. Specifically, lower levels of total protein and albumin were associated with longer healing time and extended hospitalisation.
Conclusion: Surgical site infections are common, especially in high-risk patients. SSI costs hospitals a lot. SSI research is underway. This study used Negative Pressure Wound Therapy (NPWT) as a prophylactic dressing for closed incisional wounds in 60 patients and compared its efficacy to conventional dressings. Based on relative risk analysis, CiNPWT prevented SSI after one year. NPWT significantly reduced seroma formation. Negative Pressure Wound Therapy (NPWT) shortened wound healing and hospitalisation. Negative pressure wound therapy (NPWT) reduced wound complications like dehiscence, blistering, necrosis, and reoperation or rehospitalization. These findings were not statistically significant. NPWT reduced SSI.
Material and Methods: The Institutional Ethics Committee approved this single-center, parallel, randomised controlled trial, which followed the Declaration of Helsinki. If they were 18–65 year old , patients were eligible. All surgery patients undergoing abdominal surgery and closed abdominal surgical wounds who received negative pressure wound therapy or conventional therapy. Exclusion criteria included abdominal pathology re-explored or re-operated and inability to consent. Trial participants received an information leaflet and gave written consent.
Result: The primary objective to assess the relative risk of development of SSI in the ciNPWT, the relative risk of development SSI in CiNPWT group was found to be 0.69 and 1.44 in group with conventional dressing, thus CiNPWT was found to be protective for SSI in incisional wound. CiNPWT and conventional patients were mostly 31-60 years old. 84 patients (70%) were male, while 36 (30%) were female in the study cohort.NPWT reduced wound complications like soakage and dehiscence by 20% on the 14th day after surgery. A 0.013 p-value indicated statistical significance. NPWT reduced wound complications like soakage and dehiscence on the 21st day after surgery. The 18.33% reduction was statistically significant at 0.0134. Negative Pressure Wound Therapy (NPWT) reduced soakage and dehiscence by 10% in serial follow-ups on the 30th day post-surgery. The study revealed a negative correlation between the levels of Total Serum Protein and Serum Albumin and both wound healing duration and duration of hospital stay. Specifically, lower levels of total protein and albumin were associated with longer healing time and extended hospitalisation.
Conclusion: Surgical site infections are common, especially in high-risk patients. SSI costs hospitals a lot. SSI research is underway. This study used Negative Pressure Wound Therapy (NPWT) as a prophylactic dressing for closed incisional wounds in 60 patients and compared its efficacy to conventional dressings. Based on relative risk analysis, CiNPWT prevented SSI after one year. NPWT significantly reduced seroma formation. Negative Pressure Wound Therapy (NPWT) shortened wound healing and hospitalisation. Negative pressure wound therapy (NPWT) reduced wound complications like dehiscence, blistering, necrosis, and reoperation or rehospitalization. These findings were not statistically significant. NPWT reduced SSI.
Keywords:
General Surgery; Negative Pressure Wound Therapy; Surgical Site Infections.