The Positive Outcomes Associated with the use of Incisional Negative Pressure Wound therapy with 6 patients who were considered high risk for wound complications

Background:

This poster demonstrates the successful outcome for 6 surgical patients at high risk for wound complications.  In spite of advances in aseptic technique, surgical site infections (SSIs) continue to be a major source of patient morbidity and represent considerable burden to the health care system worldwide.  In fact, the development of an SSI can be associated with costs as high as $20,000 per patient ¹.   There is emerging literature suggesting the benefits of application of negative pressure wound therapy (NPWT) to reduce SSIs .

It has been proposed that negative pressure stimulates wound healing by improving perfusion to the wound.  This has been seen in open wounds and now is more recently being applied to closed surgical wounds thought to be at high risk for infection or dehiscence.² Another theoretical advantage of Incisional NPWT is prevention of subcutaneous seromas/hematomas that secondarily become infected.³

Method:

Six patients deemed to be at high risk for surgical site complications had NPWT applied to their closed incision. The surgical cases included:  five abdominal surgeries, a bariatric case, one orthopedic.  Four cases included individuals with ostomies.  Bond et al. noted that obesity, colonic surgery, operative time and the presence of a stoma to be significant contributors to SSI.  Risk factors included one or more of the following: obesity, systemic infection, wound infection, ostomies, hemodynamic instability and disease conditions including malignancy and Crohns.

Results:

In all instances the patients avoided development of SSI or incisional complications. This poster demonstrates with photos the visual appearance of the incision lines on post –operative day 5.

Conclusion

These 6 case studies suggest further exploration is necessary with respect to the use of incisional NPWT, as our experience demonstrated avoidance of SSI in high-risk patients undergoing major abdominal and orthopedic surgery.