Prevalence of Surgical Site Infection Comparing Postoperative Negative Pressure and Conventional Dressings

Abstract

Purpose The purpose of this study was to compare the prevalence of surgical site infection (SSI) between children whose umbilical incision was covered with a negative pressure or conventional dressing following laparoscopic surgery. Background Covering surgical incisions provides reinforcement to wound closures, a surface to absorb exudate, and a barrier against bacteria to prevent SSIs. A conventional practice for laparoscopic procedures is to cover umbilical incisions with adhesive strips and/or surgical glue. Postoperative SSI is common and can lead to slowed healing and poor outcomes. Negative pressure dressings applied postsurgically may prevent infection by providing a better barrier to bacteria. However, there is limited data available to indicate which umbilical incision dressings are associated with fewer SSIs. Design This study used a retrospective comparative design. Sample/Setting Following institutional review board approval, the electronic medical records of 486 children, with mean age of 11.7 years, ranging from 1 month to 20 years, 58% male, 84% White race, and who had a laparoscopic appendectomy in a large medical center, were queried. Procedures Documentation of postoperative SSI, age, race, gender, BMI, laparoscopic procedure, and umbilical or periumbilical incision information was collected and analyzed. Findings Ten patients acquired SSI; the rate was not statistically significant. Those with vacuum dressings were more likely to have single port laparoscopic appendectomy and a transumbilical incision. There were no statistically significant correlations among the other variables. Implications Although preventing SSI is important, in this sample few infections were found. Therefore, a simple umbilical vacuum dressing offers a safe and attractive alternative to conventional postoperative dressings.