Closed-incision negative-pressure wound therapy reduces superficial surgical site infections after open colon surgery: an NSQIP Colectomy Study

Abstract

The use of closed incision negative pressure wound therapy (iNPWT) has increased in the last decade across surgical fields, including colectomy. Compare postoperative outcomes associated with use of (iNPWT) following open colectomy from a large national database. A retrospective review of patients who underwent operations from 2015-2020 was performed using National Surgical Quality Improvement Program (NSQIP) Targeted Colectomy Database. Intraoperative placement of iNPWT was identified using Current Procedural Terminology (CPT) codes in patients undergoing open abdominal operations with closure of all wound layers including skin. Propensity score matching was performed to define a control group who underwent closure of all wound layers without iNPWT. Patients were matched in a 1:4 (iNPWT vs. control) ratio and postoperative rates of superficial, deep and organ-space SSI, wound disruption, and readmission. Between 2015-2020, iNPWT was used in 483 (0.6%) undergoing open colectomies. A matched cohort of 1884 was selected. Patients with iNPWT had longer median operative time (170 [IQR 129-232] vs. 161[IQR:114-226] minutes, p<0.05) (Table 2). Compared to patients without iNPWT, Patients with iNPWT experienced a lower rate of 30-day superficial incisional SSI (3% vs. 7%, p<0.05) and readmissions (10% vs 14%; p < 0.05). iNPWT did not decrease risk of deep SSI, organ-space SSI, or wound disruption. Although there is a slightly increased operative time, utilization of iNPWT in open colectomy is associated with lower odds of superficial SSI and 30-day readmission. This suggests that iNPWT should be routinely utilized in open colon surgery to improve patient outcomes.