Low-cost prophylactic negative pressure wound therapy using central suction device in preventing surgical site infections in patients undergoing emergency laparotomy

Abstract

Background: The surgical site infections (SSIs) are the most common cause of nosocomial infection in surgical patients and are associated with high morbidity, considerable mortality, longer hospital stay, and increased health-care costs. Evidence suggests that incisional negative pressure wound therapy (INPWT) can decrease wound complications, but there is scanty literature regarding INPWT for high-risk laparotomy incisions. Materials and Methods: A prospective interventional randomized study was conducted over a period of 2 years from May 1, 2018, to April 30, 2020. The enrolled patients were randomized to the study group where INPWT was applied and the control group where patients were subjected to conventional wound dressings. Results: Out of 85 patients undergoing emergency laparotomy, 36 patients were allocated to the study group and 38 patients to the control group after meeting the exclusion criteria. Baseline demographic characteristics were similar in both the groups. The relative risk (95% confidence interval) of SSI, burst abdomen, and rehospitalization was significantly more in the control group (study versus control group): 0.65 versus 1.4, 0.67 versus 1.33, and 0 versus 2.03, respectively. Conclusions: Prophylactic use of NPWT is a safe and effective method for preventing SSI and other wound complications in emergency laparotomy for peritonitis, which is a major deciding factor in final wound outcome in such cases.