Negative Pressure Dressings Research Articles

Continuous Positive and Negative Pressure Dressing - A Novel Approach in the Treatment of Auricular Seroma

Continuous Positive and Negative Pressure Dressing - A Novel Approach in the Treatment of Auricular Seroma

Evaluation of Negative Pressure Dressings for Closed Surgical Incisions in Decreasing Surgical Site Infections After Emergency Laparotomy: A Randomized Controlled Study.

Objectives The aim of this study is to compare the effectiveness of negative pressure dressings (NPDs) versus conventional dressings for closed surgical incisions after emergency midline laparotomy, focusing on their impact on surgical site infection (SSI) rates, wound dehiscence, hospital stay duration, and cosmetic outcomes. Methods The randomized controlled study was conducted over 24 months, involving 80 patients aged 18-65 years who had peritonitis and underwent emergency midline laparotomies. Patients with diabetes mellitus, a BMI >35 kg/m², immunocompromised conditions, or those requiring re-exploration within 30 days of surgery were excluded. The participants were randomly assigned into two groups using a computer-generated randomization table: Group A, the case group, consisted of 40 patients who received NPDs, while Group B, the control group, included 40 patients who received conventional dressings. Data were recorded in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA), with a p-value of <0.05 considered statistically significant. Results The overall occurrence of SSIs within the 30-day follow-up period was significantly lower in the NPD group compared to the conventional dressing group (30% vs. 70%, p < 0.05). The mean duration of hospital stay was 14.85 ± 10.43 days for the NPD group and 15.4 ± 9.75 days for the control group, with no statistically significant difference (p = 0.712). The mean Vancouver Scar Scale score was 5.3 ± 2.47 in the NPD group and 6.5 ± 2.14 in the control group, also showing no statistically significant difference (p = 0.11). Conclusions NPDs significantly reduced the incidence of SSIs compared to conventional dressings, but they did not have a significant impact on scar cosmesis or the duration of hospital stay.

37 Evaluation of Prophylactic Negative Pressure Wound Therapy Versus Standard Surgical Dressings on Wound Outcomes in Posterior Spinal Surgery Patients: A Systematic Review and Meta-Analysis

Abstract Aim Negative pressure wound therapy has frequently been used in a variety of surgical specialities, yet its effectiveness as a prophylactic therapy in spinal surgery remains unclear. A comprehensive systematic review and meta-analysis was performed, incorporating the most recent evidence, addressing this paucity in the literature. Method A systematic search of the literature from inception to June 2023 was conducted using the following databases: Ovid Medline, EMBASE, Cochrane Register of Controlled Trials (CENTRAL) and Web of Science. All included studies assessed primary wound closure for posterior spinal surgical incisions. Evidence was quality assessed and outcomes of interest were meta-analysed using odds ratios, comparing negative pressure wound therapy and standard dressing groups. Results Seven studies (n = 1319, mean age = 59.9 years, 55.8% male) were included. Patients with negative pressure dressings had a reduced risk of surgical site infection (odds ratio = 0.45, 95% CI 0.29 to 0.72, p &amp;lt; 0.001). Wound dehiscence approached significance favouring negative pressure dressings (odds ratio = 0.53, 95% CI 0.26 to 1.06, p = 0.07). Patients requiring a return to theatre for wound related complications showed no significant difference between groups (odds ratio = 0.66, 95% CI 0.37 to 1.18, p = 0.16). Conclusions Negative pressure wound therapy reduces the risk of surgical site infection in posterior spinal surgery patients. Given that surgical site infection in spine surgery is associated with significant morbidity and financial costs, implementation of prophylactic negative pressure wound therapy for this patient demographic may be beneficial.

Minimizing the Risk of Surgical Site Infection Following Hip Fracture Operation.

Introduction: Hip fractures are the most common serious injury in the elderly, associated with disability, morbidity, and mortality. Surgical site infection (SSI) is a serious post-operative complication. This prospective cohort study outlines how our center made cumulative improvements in SSI incidence rates, reaching a 12-month average of 0.5%. Methods: All patients undergoing hip fracture operation between 2016 and 2021 were included. The primary outcome measure was confirmed SSI, according to the Public Health England definition. Results were compared with the baseline recordings by an independent SSI team in 2013. Demographic data were compared with National Hip Fracture Database records. Peri-operative infection control and wound management tactics introduced between 2014 and 2021 were collated to gain an overview care bundle. Results: Baseline recordings identified a 9.0% SSI rate in a three-month observation period. In our study, 3,138 hip fracture operative cases were completed between October 2016 and December 2021. There were 9 superficial and 32 deep infections identified, yielding an overall infection rate of 1.3%. However, when analyzing the 12-month average, there was consistent decline in SSI from the baseline 9.0% in 2013 to 0.5% in 2021 (p < 0.05). A peri-operative care bundle included pre-operative bleeding risk assessment. Intra-operatively, double preparation and draping is used for arthroplasty. Broad-spectrum antibiotic agents and tranexamic acid are administered. Meticulous hemostasis and watertight wound closure are observed. Anti-coagulated patients received negative pressure dressings. Post-operatively, a dedicated senior lead team provided daily inpatient review of patients, with urgent consultant review of all wound healing concerns. Conclusion: Patients with a hip fracture have numerous risk factors for SSI. A dedicated multi-focal tactic, adopted by a multi-disciplinary department, can yield substantial risk reduction. Each intervention is evidence based and contributes to cumulative improvement. By prioritizing infection prevention, we have minimized the need for complex infection management interventions and achieved an annual saving of £860,000 for our trust.

Role of Prophylactic Negative Pressure Dressings in Determining the Surgical Site Infection (SSI) on Closed Laparotomy Wounds in Abdominal Surgery: Randomized Controlled Open Label Trial: Vacuum Assisted Closure (VAC) Trial in a Tertiary Care Setup

Background: Surgical site infections (SSIs) continue to pose a significant challenge in postoperative care, particularly in abdominal surgeries, due to their prevalence and the associated increase in morbidity, mortality, and healthcare costs. Despite advancements in surgical techniques and aseptic measures, the incidence of SSIs remains high, underscoring the need for innovative preventive strategies. Objective: This study aims to evaluate the efficacy of vacuum-assisted closure (VAC) dressings compared to standard dressing methods in reducing the incidence of surgical site infections in patients undergoing closed laparotomy wounds in abdominal surgeries. Methods: A randomized controlled trial was conducted over six months at Civil Hospital Karachi, involving 116 patients undergoing abdominal surgeries. Participants were randomly assigned to receive either the VAC dressing or standard dressing postoperatively. The primary outcome measured was the incidence of SSIs within 30 days post-surgery, evaluated using the CDC classification and Southampton wound grading system. Data were analyzed using SPSS version 25.0, employing descriptive statistics, independent t-tests, and Chi-square tests for continuous and categorical variables, respectively. Results: The VAC group demonstrated a significantly lower incidence of SSIs (13.8%) compared to the non-VAC group (96.6%), with statistical significance (p &lt; 0.001). Age and BMI showed significant differences between the groups; patients in the VAC group were younger (mean age 30.84 ± 10.71 years) and had a lower BMI (mean 19.69 ± 4.16 kg/m²) compared to the non-VAC group (mean age 37.31 ± 12.83 years, mean BMI 22.07 ± 4.41 kg/m²). The duration of surgery and length of incision did not significantly differ between the groups. Conclusion: The use of vacuum-assisted closure dressings significantly reduces the incidence of surgical site infections in abdominal surgery patients, offering a superior alternative to standard dressings. This method not only enhances patient outcomes but could also lead to a reduction in healthcare costs by minimizing complications associated with SSIs.

The application of negative pressure wound treatment in oncoplastic breast surgery

&lt;p class="MsoNormal"&gt;&lt;span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-bidi-language: AR-EG;"&gt;After breast surgery, wound complications are not uncommon. In patients with breast cancer, delayed wound healing may cause poor cosmesis and postpone the start of adjuvant therapy. Since there is now disagreement about the use of preventive negative pressure dressings in closed wounds following breast surgery, the goal of our research was to examine the literature regarding the usefulness of negative pressure wound management in oncoplastic breast surgery&lt;span dir="RTL" lang="AR-EG"&gt;.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

PLASTIC SURGERY OF WOUND DEFECTS WITH FREE GRAFTS AFTER MALIGNANT SKIN TUMORS EXCISION: A PILOT STUDY.

To evaluate the effectiveness of applying negative pressure bandages (VAC bandage) in patients with malignant skin tumors after closing defects with free skin grafts and to compare it with fixation of skin grafts by the ordinary ointment bandages. 61 patients with malignant skin tumors who underwent surgical treatment at the National Cancer Institute from 2019 to 2023 were included in the study. For the wound defects closure, the split skin grafts were applied in all patients. At the time of surgery, after closing a wound defect by a split skin graft, a negative pressure dressing (VAC bandage) was applied in 41 patients for 7 days (group 1). In 20 patients, a transplanted skin graft was fixed after surgery by an ordinary ointment pressure bandage (group 2). The immediate results were evaluated one week after surgery. Complete engraftment of the flap in group 1 was observed in 53.7 ± 7.8% cases, in group 2 this result was achieved in 5.0 ± 4.8% patients (p = 0.002). The complete graft necrosis occurred in 1 case in group 1 vs. 2 cases in group 2 (p = 0.496). The results of the engraftment in postoperative wounds were significantly better in the VAC-bandage group in terms of the number of the complete engraftments compared to the conventional pressure ointment bandage group.

Negative pressure dressings and the impact on pain management on thoracic incisions in patients undergoing oesophagectomy: a pilot study.

Pain control is recognised as a crucial post-operative measure for patients undergoing oesophagectomy with a thoracotomy incision for oesophageal cancer, where ineffective breathing due to pain is directly correlated with increased morbidity. The analgesic benefits of negative pressure wound therapy (NPWT) appear to be a relatively new and emerging finding. This pilot study aims to investigate the effects of NPWT on post-operative pain control and determine the feasibility of a larger trial. Ten consecutive patients undergoing oesophagectomy were prospectively enrolled to have a PREVENA Incision Management System placed over a closed thoracotomy wound. This dressing was changed at post-operative day 5 and removed after day 10. Post-operative morbidity was recorded and analgesia was prescribed by the Acute Pain Service who were blinded to the study aims. Analgesia requirements were recorded in oral morphine equivalents (OME) and compared to 30 patients that had previously undergone oesophagectomy via thoracotomy. One patient was withdrawn from the study and there was no significant differences in patient demographics. The study group had less average daily analgesia requirements and reduced overall reported pain. Patients in the study group were less likely to develop pneumonia (44% and 57%) and less likely to require re-operation for complications of their surgery (0% and 10%). This pilot study shows reduced post-operative analgesia requirements and reduced morbidity when using NPWT over a closed thoracotomy wound, and affirms the feasibility of a future randomized control trial.

Clinical Evaluation of Medical Ozone Use in Domestic Feline Cutaneous Wounds-A Short Case Series.

Support and management of second-intention wound healing involves frequent dressing changes having different properties. Dressings can range from simple ones, such as nonadherent dressings, to more complex options, such as foam, hydrocolloid, alginate or negative pressure dressings. Seven cats were enrolled in the study with a total of nine wounds of various sizes with different etiology sizes and localizations. Three methods of local ozone administration were used to cover more of the ozone properties in the treatment of wounds: bagging, perilesional subcutaneous infiltrations and lavages with ozonated saline. Evaluation of the healing process was performed by clinical observation and wound area measurements every seven days until the complete recovery of the patients. The results of this study should encourage clinicians to consider medical ozone as a new therapeutic approach with regenerative properties in the second-intention healing of cats presenting cutaneous wounds.

Treatment and Improvement of Healing after Surgical Intervention.

The development of abnormal scars has a great impact on people's well-being, and improving scarring outcomes after surgery is a field that currently lacks consensus. This review aims to identify newly researched approaches to improving the quality of surgical scars. A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted between 13 May 2023 and 17 May 2023, in accordance with the recommendations of the PRISMA Statement. Study selection and analysis of methodological quality were performed in parts, independently and blindly, based on eligibility criteria. The 21 prospective, comparative, and randomized studies reviewed included 1057 subjects and studied approaches such as topical applications of creams with herbal extracts and silicone gels, growth factors, negative pressure dressings, oligonucleotides, intralesional injection of compounds such as botulinum toxin, skin closure techniques such as suturing and tissue adhesive, and laser treatments. There are recent research techniques that generate good results and are really promising to improve the results of surgical scars; however, the available evidence is extremely limited in some cases, and it is necessary to deepen its analysis to obtain reliable action protocols in each type of surgery.

A Novel No Foil-to-Skin Contact Technique for Vacuum-assisted Wound Closure in Patients with Sensitive Skin.

For 9 months (April-December 2022), we performed 32 vacuum wound dressings with the newly developed technique using the 3M ActiV.A.C. Therapy Unit and accessories, and Convatec's VARIHESIVE, avoiding skin contact with the adhesive films. Seven patients with 11 wounds who had sensitive skin or allergy to the conventionally used adhesive films were successfully treated with the new technique. The negative pressure wound dressings remained intact and functioned properly for up to 168 hours without compromising patients' daily activities and therapy. The novel "no foil-to-skin contact" technique for vacuum-assisted wound closure can successfully be incorporated in the treatment of patients in whom conventional negative pressure dressings are otherwise not applicable.

Secondary wound closure with anew transparent negative-pressure dressing.

Secondary healing surgical wounds can be treated with negative-pressure therapy. Dressing changes can be painful due to the strong adherence of the polyurethane foam placed in the wound. After debridement and conditioning of the wound bed, secondary surgical wound closure with asurgical suture can be performed. Cutaneous negative-pressure therapy is used preventively after primary surgical suturing. Descriptions for secondary wound closure without asurgical suture are not known to date. The preparation and handling of an innovative transparent dressing for the cutaneous application of negative-pressure therapy is demonstrated here. The dressing assembly consists of atransparent drainage film and atransparent occlusion film. Negative pressure is applied via atubing connector using anegative pressure pump. Anew method of secondary wound closure using the transparent negative-pressure dressing is presented based on acase example. The treatment cycle with instructions for making the dressing is shown in avideo.

A Comprehensive Literature Review of Fournier's Gangrene in Females.

Fournier gangrene (FG) is a rare but rapidly progressing disease with a higher mortality rate in women as compared to men. This study aims to perform a literature review about FG in females and associated mortality and morbidity. We searched databases including MEDLINE (Ovid), the National Library of Medicine (Medical Subject Headings (MeSH)), the Cochrane Database of Systematic Reviews (Wiley), as well as Embase (Ovid), Scopus, and Global Index Medicus (WHO), and reviewed literature from 2002 to 2022 and selected 22 studies that met our study's inclusion criteria, which included 134 female patients with a mean age of 55±6 years. The perineal abscess was a more common nidus (n=41, 35%; 95%CI 23-39%) than vulvar pathology (n=29, 22%; 95%CI 15-30%). The most common initial presentation was cellulitis (n=62, 46%; 95%CI 38-55%), followed by perineal pain (n=54, 40%; 95%CI 32-50%), fever (n=47, 35%; 95%CI 27-43%), and septic shock (n=38, 28%; 95%CI 21-37%). Escherichia coli was the most frequently identified bacteria (n=48, 36%; 95%CI 28-46%). All patients had treatment with a mean of three (SD 2) debridement and those with negative pressure dressings received fewer debridements than those who received a conventional dressing. However, of those who had surgical intervention, 28 (20%; 95%CI 14-29%) patients underwent diversion colostomy. General surgeons performed 78% (n=104) of cases out of which 20% (n=20) were consulted by obstetrician-gynecologists, 14% (n=18) were treated by urologists, and only 8% (n=10) by plastic surgeons. The mean length of stay in the hospital was 24±11 days, and the gross mortality rate was 27 (20%; 95%CI 14-28%). In conclusion, while females have a low incidence rate of FG, they carry a higher mortality rate. Lack of cardinal signs and delayed presentation to the hospital from the onset ofsymptoms are some possible causes for the increased mortality rate along with the disease process being under-recognized in women. A high index of clinical suspicion is essential to avoid delay in the definitive management coupled with an early surgical consult and establishing a common general care pathway could minimize mortality and morbidity.

Intrathoracic negative pressure therapy for pleural empyema using an open-pore drainage film.

We report our initial experience with intrathoracic negative pressure therapy (ITNPT) in the stage-adjusted treatment of pleural empyema (PE) based on acase series. ITNPT represents afurther development for intrathoracic use. After thoracic surgical open debridement, an intrathoracic negative pressure dressing was inserted. The drainage elements were athin open-pore double-layer drainage film (OF) with open-pore polyurethane foams (PUF). Only the OF was placed in direct contact with the lung parenchyma. Negative pressure was generated using an electronic pump (continuous suction, -75 mm Hg). In revision thoracotomies, ITNPT was stopped or continued depending on local findings. In total, 31patients with stageII andIII pleural empyema underwent ITNPT, which was administered during the primary procedure (n = 17) or at revision (n = 14). Treatment duration was amean of 10days (2-18days) with amean change interval of 4days (2-6days). Intrathoracic negative pressure dressings were applied amean of 3.5 (1-6) times. The empyema cavity continuously reduced in size and was cleansed by the suction. The OF has aminimum intrinsic volume with maximum absorption surface. Once negative pressure is established, there is no intrathoracic dead volume and the parenchyma can expand. The protective material properties of OF make ITNPT suitable for the treatment of pleural empyema. Targeted local intrathoracic drainage of the septic focus is apossible adjunct to surgery. The surgical dressings must be changed repeatedly. The method is suitable for the treatment of complex stageII andIII pleural empyemas. The OF can be used as an intrathoracic drainage element for ITNPT in pleural empyema. This new application option expands the range of indications for negative pressure therapy.

Intrathoracic negative pressure therapy of pleural empyema using an open-pored drainage film

We report our initial experience with intrathoracic negative pressure therapy (ITNPT) in the stage-adjusted therapy of pleural empyema (PE) based on a case series. ITNPT represents a further development in negative pressure therapy that is designed to be used in the thoracic cavity. After thoracic surgical open debridement, an intrathoracic negative pressure dressing was inserted. The drainage elements used were a thin open-pore double-layer drainage film (OF) with open-pore polyurethane foams (PUF). Only the OF was placed in direct contact with the lung parenchyma. Negative pressure was generated using an electronic pump (continuous suction, -75 mm Hg). In revision thoracotomies, ITNPT was stopped or continued depending on local findings. 31patients with stageII and III pleural empyemas were treated. ITNPT was administered at the time of primary procedure (n = 17) or revision (n = 14). ITNPT was given over a duration of m = 10 days (2-18days), change interval m = 4d (2-6d). The application of intrathoracic negative pressure dressings was performed m = 3.5 (1-6) times. The empyema cavity continuously reduced in size and was cleansed by the suction. The OF has a minimum intrinsic volume with maximum absorption surface. Once negative pressure is established, there is no intrathoracic dead volume and the parenchyma can expand. The protective material properties of OF make ITNPT suitable for the treatment of pleural empyema. Targeted local intrathoracic drainage of the septic focus is a possible adjunct to surgery. The treatment regimen requires surgical dressings to be changed repeatedly. The method is suitable for the treatment of complex stage II and III pleural empyemas. The OF can be used as an intrathoracic drainage element for ITNPT in pleural empyema. This new application option expands the range of indications for negative pressure therapy.

Comparison of Negative Pressure Dressing and Conventional Dressing in the Management of Skin Grafts at the Donor Site of the Latissimus Dorsi Flap

Introduction. Delayed and incomplete healing of the skin graft at the donor site of an LD flap is common because of seroma formation. The authors aimed to evaluate whether the application of an NPD could improve the healing process after STSG at LD donor sites. Materials and Methods. From July 2019 to September 2021, 32 patients underwent STSG with NPD at the LD donor site, and 27 patients underwent STSG with TBDs. Data were collected and analyzed using the chi-square test, t test, and Spearman correlation test. Results. The overall Spearman correlations of graft loss with seroma, hematoma, and infection were 0.56 (P &lt;.01), 0.64 (P &lt;.01), and 0.70 (P &lt;.01), respectively. Compared with the TBD group, the STSG take rate was significantly higher in the NPD group (90.3% vs 84.5%, P =.046) while the seroma rate (18.8% vs 44.4%, P =.033), graft loss (9.4% vs 29.6%, P =.047), and mean length of stay (10.9 ± 1.8 vs 12.1 ± 2.4, P =.037) were significantly lower. Conclusions. NPDs for STSG at the LD donor site contribute significantly to improved graft acceptance with reduced seroma formation.

DIFFERENT APPROACHES IN THE MANAGEMENT OF DIABETIC FOOT ULCERS – EXPERIENCE AT A TERTIARY CARE HOSPITAL

Aims and Objectives: To compare the outcomes of the usage of the negative pressure wound therapy (NPWT) using vacuum assisted wound closure/ Collagen granules/ Offloading techniques with the conventional moist gauze dressing in the treatment of diabetic foot ulcers (DFU). Methods: Prospective, interventional study. Study conducted at B.L.D.E (DU)’s Shri B.M.Patil Medical College Hospital and Research Center, Vijayapur over a period of 5 years. The demographic characteristics, type of foot lesions and treatment with different modalities of dressings and outcome were studied. 50 cases in each group – NPWT/Collagen granules dressing/ offloading techniques and conventional moist gauze dressings were allocated alternatively. Results: 200 patients were included in the study, saw the gradual increase in the granulation tissue development, but the results were better in other groups than the conventional group and the collagen dressing group had more granulation tissue from week 1. There was early recovery among the other groups when compared to the conventional methods. The mean recovery were least in the collagen dressing group. 90% had good outcome in the negative dressing group. The outcome was 92% among the off loading group and 96% good outcome among the collagen group. But the conventional group had only 64% good outcome. And the difference was statistically significant. Conclusion: The comparison of different methods to treat the diabetic foot ulcer showed that collagen method of dressing to be superior to others followed by offloading and then by topical negative pressure dressing. The conventional method had less favorable and slow outcome.

Therapeutic strategies for retention of cranioplasty titanium mesh after mesh exposure

BackgroundTitanium mesh exposure after cranioplasty is a possible complication and is usually managed by mesh removal and flap transfer, but the advantages of the rigid prosthesis are then lost. This study aimed to present our experience with negative pressure wound therapy combined with soft tissue dilation for retaining the titanium mesh in patients with mesh exposure after cranioplasty.MethodsThis retrospective study included patients treated between 01/2016 and 05/2019 at the Jiangyin Hospital Affiliated to Southeast University School of Medicine. The wound was cleaned, and a cystic space was created for the tissue dilator, which was used with a self-designed negative pressure dressing. After the target dilation was achieved, the repair was conducted while retaining the titanium mesh.ResultsEight patients were included (seven males and one female; 53.6 ± 8.8 (range, 43–65) years of age). The exposed mesh area ranged from 1 × 1 to 4 × 5.5 cm. The thinning scalp area around the exposed mesh ranged from 3.6 × 3.8 to 4 × 5.5 cm. Five patients had positive wound cultures and received sensitive antibiotics. The dilator embedding time was 20–28 days. The time of negative pressure wound therapy was 25–33 days. The hospital stay was 30–41 days. Primary wound healing was achieved in all eight patients. There were no signs of recurrence after 6–18 months of follow-up. The cranial CT scans were unremarkable.ConclusionsNegative pressure wound therapy combined with soft tissue dilation for exposed titanium mesh after cranioplasty might help retain the titanium mesh.

SP7.8 The SUNRRISE Trial – Single Use Negative pRessure dressing for Reduction in Surgical site infection following Emergency laparotomy

Abstract Background Surgical Site Infections (SSI) are common after abdominal surgery, and more so after emergency laparotomy. Despite Single Use Negative Pressure Dressings (SUNPDs) having mixed evidence regarding effectiveness, they are recommended in the WHO SSI Prevention guidelines. SUNRRISE is an international, multi-centre, trainee devised, led and delivered randomised controlled trial, funded by the NIHR (UK) and MRFF (Australia). It investigates whether a SUNPD reduces the risk of SSI within 30 days of emergency laparotomy. Method Patients were randomised between SUNPD (PICO7©, Smith and Nephew) and surgeon's preference of dressing. Patients were eligible if they underwent an emergency laparotomy with an incision of at least 5cm that was primarily closed at the end of the operation. SSI was assessed at day 5–10, via a patient diary while the patient was at home and at day 30–44 by a blinded, trained wound assessor. Results 840 patients were randomised from 34 centres across the UK and Australia. Intention to treat analysis showed no difference in SSI between the two groups (SUNPD-28%, Control-27%, p=0.75). There was also no difference in all secondary outcomes- length of stay (9 vs 11, p=0.14), hospital readmission for wound related complications (3% vs 3%, p-0.96, rates of wound related complications (19% vs 18%, p-0.79), pain (1.8 vs 1.8, p-0.61) and quality of life (SF-12 &amp; EQ5D-5L). Conclusion SUNRRISE is a multicentre, assessor blinded, phase III RCT that provides robust evidence that single-use negative pressure dressings are not effective in reducing surgical site infections in patients undergoing an emergency laparotomy.

A Comparative Study of Negative Pressure Dressing with and without Silver Alginate to Promote Faster Wound Healing in Chronic Wounds

Objective: To determine the effectiveness of negative pressure dressing with silver alginate hydro-fibre dressings in managing chronic wounds compared to negative pressure dressing without silver alginate hydro-fibre dressings.&#x0D; Study Design: Cross-sectional analytical study.&#x0D; Place and Duration of the Study: Department of Plastic and Reconstructive Surgery at Dr Ruth K.M. Pfau Civil Hospital Karachi, from Jan to Jul 2021.&#x0D; Methodology: All patients above 18 years of age of either gender presented with more than six weeks of wound duration, hemoglobin levels more than 10 g/dl, platelet count above 150 x 10E9/L, and size of the wound more than 10*10cm were consecutively enrolled. Negative pressure dressings with and without hydro-fibre dressings were applied. A team of plastic surgeons monitored the wound site to assess granulation tissue by noting the size of the wound and pain severity. The outcome was assessed at four weeks.&#x0D; Results: Of 62 patients, the median age was 43 (32.5-56.7) years. There were 37 (59.67%) males and 25 (40.32%) females. The outcome assessment at four weeks showed that overall pain was observed in 34 (54.83%) patients. Pain severity (p-value &lt;0.001) and low granulation score (p-value 0.025) were found significantly higher in patients who received negative pressure dressing without silver alginate as compared to the patients who received negative pressure dressing with silver alginate. A significant median difference in granulation days was observed between groups (p-value &lt;0.001).&#x0D; Conclusion: Combining negative pressure dressings with silver alginate dressing has positive effect on the chronic wound compared to using negative pressure dressings alone.