Abstract
Objectives. Groin wounds following vascular surgery are highly susceptible to healing disturbances, with reported site infections reaching 30%. Negative pressure incision management systems (NPIMS) are believed to positively influence the prevention of surgical wound-healing disturbances (WHD) and surgical site infections (SSI). NPIMS placed directly after closure of the surgical wound is thought to result in fewer infections; we analysed its effect on postoperative wound infections in patients after vascular surgery via the groin. Methods. From May 2012 to March 2013 we included 90 surgical patients; 40 received a NPIMS. All patients with WHDs were labelled and subanalysed for surgical site infection in case of positive microbiological culture. These infections were graded according to Szilagyi. Number of WHDs and SSIs were compared across cohorts. Results. Patient and perioperative characteristics were equal, except for a significantly higher number of emergency procedures among non-NPIMS patients. We found no significant differences in number of WHDs, SSIs, or Szilagyi grades between the two cohorts. Conclusion. The equal number of SSIs across cohorts showed that NPIMS could not reduce the number of surgical site infections after vascular groin surgery.
Highlights
Negative pressure incision management systems (NPIMS), such as Prevena (KCI USA, Inc., San Antonio, TX), [1] are believed to have a positive effect in the prevention of surgical wound-healing disturbances and surgical site infection
It is known that groin wounds after vascular surgery are highly susceptible to wound-healing disturbances, with reported site infections varying up to 30% as reported in previous studies [3,4,5,6]
Infection only involves the dermis Infection extends into the subcutaneous tissue and does not invade the arterial implant Arterial implant is involved in the infection
Summary
Negative pressure incision management systems (NPIMS), such as Prevena (KCI USA, Inc., San Antonio, TX), [1] are believed to have a positive effect in the prevention of surgical wound-healing disturbances and surgical site infection. Matatov et al published recently a retrospective study on the use of NPIMS on groin wounds in vascular surgery patients [3]. They found a reduction from 30% site infections in the control group to 6% site infections in the NPIMS group (P = .001). Based on these promising data we started to apply NPIMS on groin wounds after vascular surgery. We will describe our first experience with this negative pressure wound management system
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