Alisan Fathalizadeh, MD, MPH1, Eric Weiss, MD1, Madeline Tadley2, Mark Kaplan, MD, FACS1, Pak Leung, MD, MSc, FACS1. 1Albert Einstein Medically Center, 2Sidney Kimmel Jefferson Medical College
Objective: To demonstrate that negative pressure therapy can reduce postoperative wound complications on clean closed incisions. A standardized patient selection protocol was created and implemented for utilization of Incisional Negative Pressure Wound Therapy (INPWT) in high risk patients. We present our institutions one-year experience using the innovative protocol.
Methods: An institutional protocol was created to identify surgical patients at high risk for incisional complications. Patients undergoing high risk procedures with two or more preoperative risk factors were appropriate candidates for INPWT. The PrevenaTM Incision Management System was used according to the manufacturer’s specifications. Medical records were reviewed retrospectively. The primary outcome was incidence of surgical site infection (SSI) within 30 days. The secondary outcomes included cellulitis, wound dehiscence, seroma formation, soft tissue necrosis and mortality.
Results: From July 2015 to October 2016, 72 patients suitable for INPWT were identified. Forty-three percent of these patients had more than four preoperative risk factors. The most common preoperative risk factors were perioperative hyperglycemia (72%), malnutrition (61%), obesity (58%) and diabetes (54%). Twenty-six percent of our patients had a BMI ≥40 kg/m2. Laparotomy was the most common surgical procedure (76%) and 44% of the procedures were contaminated or dirty. Four patients developed superficial SSI (5%) and 10 patients developed wound dehiscence (13%) within 30 days of surgery.
Conclusions: Our protocol identified and implemented INPWT in high risk patients with excellent wound care outcomes observed. Our initial experience illustrates that INPWT is cost-effective and can reduce incisional complication if used on carefully selected patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88282
Program Number: P486
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster