Vy Nguyen, MD, Mitchell Webb, MD, O. Neely Panton, MD. University of British Columbia
Background: Superficial surgical site infection (SSI) is a preventable postoperative complication that impacts length of hospital stay, health care spending, and patient morbidity/mortality. Numerous trials have sought to establish perioperative protocols to reduce the incidence of SSI. Recently, literature has been produced on the efficacy of incisional Negative Pressure Wound Therapy (iNWPT) in orthopaedic, vascular, and cardiac surgical patient populations. Previous studies in general surgery have demonstrated a reduction of up to 50% in the SSI rate with the use of iNWPT. Currently there is no randomized data to support the use of iNWPT. Our objective is to examine the effect of iNWPT on wound complication rates in elective colorectal resections both open and laparoscopic. This will be accomplished in a single center, prospective randomized clinical trial.
Methods: This is a single-institution, prospective, randomized, open-label, superiority trial. Patients scheduled for elective colorectal resection with or without creation of an ostomy (open or laparoscopic) will be considered eligible. Exclusion criteria includes patients who are under 19, pregnant, immune compromised, allergic/sensitive to adhesive dressings, operations performed under an emergent basis, without an anastamosis(e.g. APR/Hartmann), for palliation or without a midline incision made for specimen extraction. Cases involving additional procedures at time of CRR (eg. hernia repair) will also not be included. Patients will be randomized to receive iNWPT or conventional dressings. Primary outcomes will be wound complications within the first 30 post operative days. SSI rate will also be reported as a subgroup analysis. Secondary outcomes will include length of stay, # of post-operative visits in the 30 day period, complications, wound vac specific complications and patient satisfaction. Data will be collected prospectively through our Enhanced Recovery After Surgery (ERAS) audit group.
Results: Currently recruitment is yet to start however we hope to present preliminary results at the upcoming SAGES meeting in March 2017.
Conclusions: We hope to show that iNWPT leads to a lower incidence of wound complications and should be integrated in to a standard ERAS care pathway.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80663
Program Number: P332
Presentation Session: Poster (Non CME)
Presentation Type: Poster