Avery C. Williams MD, Kripa Shrestha MBBS, MPH, MS, Alexis Cruz MD, Anastazia H. Gilman MD, MBA, Jonathan Huynh MD, Justin Vaughan MD, MS, Ariel P. Santos MD, MPH, FRCSC, FACS, FCCM
Background: Surgical site infection (SSI) is one of the most common healthcare-associated infections. The use of negative pressure wound therapy (NPWT) has decreased the overall rate of SSI, wound dehiscence, and length of hospital stay in surgical conditions. This study aims to determine the impact of NPWT applied to closed surgical incisions in patients with coexisting ostomies undergoing exploratory laparotomies.
Methods: A retrospective study of patients who underwent exploratory laparotomies between 2017 and 2019 was conducted. Negative pressure wound therapy was compared to standard post-operative surgical wound dressing. A sub-analysis of patients with ostomies was performed.
Results: A total of 286 patients who underwent exploratory laparotomies were identified; 51 patients received NPWT and 235 received standard dressing. The NPWT group had a higher percentage of patients with ostomies (37.3% vs. 20.4%, P = 0.016), of which 25.5% were colostomies (vs. 12.3%) and 11.8% were ileostomies (vs. 8.1%) with P = 0.002. No significant differences in the overall rate of SSI (7.8% vs. 5.5%, P = 0.517), wound dehiscence (7.8% vs. 2.1%, P = 0.57), and seroma formation (3.9% vs. 2.1%, P = 0.612) were observed. The mean length of ICU stays (3.5 vs. 7.0, P = 0.051) and the number of unplanned reoperation (5.9% vs. 16.6%, P = 0.051) were lower in the NPWT group compared to the control group. Sub-analysis of patients with stomas found no significant difference in SSI.
Conclusions: In our study, the use of NPWT on closed surgical incision wound was not associated with the reduction of SSI in patients with ostomies. Large studies are needed to determine significant benefits in these patients.
Keywords: negative pressure wound therapy, surgical site infection, ostomy, exploratory laparotomy
Article citation: Williams AC, Shrestha K, Cruz A, Gilman AH, Huynh JK, Vaughan J, Santos A. Effect of Negative Pressure Wound Therapy in Exploratory Laparotomies with Coexisting Ostomy. Southwest Respiratory and Critical Care Chronicles 2022;10(44):22–28
From: Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 6/9/2022
Accepted: 6/30/2022
Conflicts of interest: none
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