6298 Does Negative Pressure Wound Therapy Improve Outcomes for High Risk Gynecologic Oncology Patients?

Stephanie Kearney, RN, BSN, CWOCN, Karmanos Cancer Center, CWOCN, Detroit, MI and Carole Bauer, RN, MSN, ANP-BC, OCN, CWOCN, Karmanos Cancer Center, Wound, Ostomy, Continence Nurse Practitioner, Detroit, MI
Topic:

Negative pressure wound therapy (NPWT) has been used for treatment of many types of open wounds.  It has been postulated that NPWT can also be used to prevent postoperative incisional complications for high risk patients.  Patients who are risk for surgical wound complications include the obese (BMI>30), diabetic, poor vascular status, poorly nourished, smokers, steroid use, anemia, and presence of ascites.  Those patients with transabdominal incisions have been noted to have a higher rate of incision compromise in our institution. 

Purpose:

To test the use of an evidence based algorithm to guide the use of NPWT on closed incisions and to determine if negative pressure therapy applied to transabdominal wounds will improve patient outcomes for a group of ten high risk gynelocologic oncology patients. 

Objective:

To develop an evidence-based algorithm to guide the application of NPWT to closed incisions on patients who meet criteria and then evaluate the outcome of the application of the NWPT to the clean, closed low transverse incisions of adult cancer patients.

Outcome:   

Ten gynecologic cancer patients were chosen based on their risk for postoperative incisional complications.  For these patients who met the criteria, the NPWT was applied under sterile conditions in the operating room, and left in place for 3 to 5 days.  The NPWT was removed by the WOCN and the incision assessed.  The patient was then assessed again on their postoperative appointment with the surgeon.  Of the ten patients, only one had disruption of the suture line.