Abstract
AimSurgical site infection in colorectal surgery is associated with significant healthcare costs, which may be reduced by using a closed‐incision negative‐pressure therapy device. The aim of this study was to assess the impact of closed‐incision negative‐pressure therapy on the incidence of surgical site infection.MethodIn this retrospective cohort study we evaluated all patients who had undergone high‐risk open colorectal surgery at a single tertiary care centre from 2012 to 2016. We compared the incidence of surgical site infection between those receiving standard postoperative wound care between 2012 and 2014 and those receiving closed‐incision negative‐pressure therapy via a customizable device (Prevena Incision Management System, KCI, an Acelity company, San Antonio, Texas, USA) between 2014 and 2016. A validated surgical site infection risk score was used to create a 1:1 matched cohort subset.ResultsNegative pressure therapy was used in 77 patients and compared with 238 controls. Negative pressure patients were more likely to have a stoma (92% vs 48%, P < 0.01) and to be smokers (33% vs 15%, P < 0.01). Surgical site infection was higher in control patients (15%, n = 35/238) compared with negative pressure patients (7%, n = 5/77) (P = 0.05). On regression analysis, negative pressure therapy was associated with decreased surgical site infection (OR 0.27; 95% CI 0.09–0.78). These differences persisted in the matched analysis.ConclusionNegative pressure therapy was associated with decreased surgical site infection. Negative pressure therapy offers significant potential for quality improvement.
Highlights
Surgical site infection (SSI) in colon and rectal surgery is common and costly
Negative pressure therapy was associated with decreased surgical site infection
The patients were similar with respect to preoperative characteristics, the closed-incision negative-pressure therapy (CINPT) group had a larger proportion of active smokers (CINPT vs control, 33% vs 15%; P < 0.01)
Summary
Surgical site infection (SSI) in colon and rectal surgery is common and costly. A 2009 national registry study showed that 4% of patients undergoing colorectal procedures were diagnosed with SSI on their index admission [1]. Readmissions following colorectal surgery are expensive, with SSI noted as the second most common cause for hospital readmission after colectomy [3,4]. Interventions that might reduce the incidence of SSI have been extensively investigated. One such intervention is the use of closed-incision negative-pressure therapy (CINPT) dressings. These dressings prevent external contamination of the incision and encourage tissue apposition, tissue perfusion and the removal of fluid and infectious material
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Schedule a callMore From: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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