Abstract
Background
Postoperative complications of surgical incisions are frequent in liver transplantation.
However, evidence justifying the use of incisional negative pressure wound therapy
to improve surgical wound outcomes remains limited.
Methods
Participating patients were randomly assigned to receive incisional negative pressure
wound therapy or standard surgical dressing on the closed surgical incision of the
liver transplantation. The primary endpoint was surgical site infection incidence
30 days postoperatively. The secondary endpoints included surgical site events (ie,
surgical site infection, dehiscence, hematoma, and seroma) and wound quality of life.
Results
Between December 2018 and September 2021, 108 patients (54 in the incisional negative
pressure wound therapy group and 54 in the control group) were enrolled in this study.
The incidence of surgical site infection at 30 days postoperatively was 7.4% in the
treatment group and 13% in the control group (P = .34). The rate of surgical site events was similar in the treatment in the and
control group (27.8% vs 29.6%, P = .83). In relation to wound quality of life, the mean score was 75.20 ± 7.27 in
the incisional negative pressure wound therapy group and 72.82 ± 10.57 in the control
group (P = .23).
Conclusion
The prophylactic use of negative pressure wound therapy on primarily closed incisions
did not significantly reduce incisional surgical site infection and surgical site
event rates after liver transplantation compared with standard surgical dressings.
Graphical abstract
Graphical Abstract
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References
- Surgical site infections in Eastern Mediterranean region: a systematic review and meta-analysis.Infect Dis (Lond). 2019; 51: 719-729
- Worldwide incidence of surgical site infections in general surgical patients: a systematic review and meta-analysis of 488,594 patients.Int J Surg. 2021; 95106136
- Biliary complications following liver transplantation.World J Gastroenterol. 2013; 19: 2841-2846
- Negative pressure wound therapy for surgical site infections: a systematic review and meta-analysis.J Adv Nurs. 2021; 77: 3980-3990
- Single-use negative-pressure wound therapy versus conventional dressings for closed surgical incisions: systematic literature review and meta-analysis.BJS Open. 2021;
- Effectiveness of negative pressure wound therapy/closed incision management in the prevention of post-surgical wound complications: a systematic review and meta-analysis.JBI Database System Rev Implement Rep. 2015; 13: 253-303
- Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of incisional negative pressure wound therapy: a systematic review of the literature.Int Wound J. 2016; 13: 1260-1281
- Negative pressure wound therapy for surgical wounds healing by primary closure.Cochrane Database Syst Rev. 2020; 5Cd009261
- Prophylactic use of negative pressure therapy in general abdominal surgery: a systematic review and meta-analysis.Surg Infect (Larchmt). 2021; 22: 854-863
- Prophylactic negative pressure wound therapy for closed laparotomy incisions: a meta-analysis of randomized controlled trials.Ann Surg. 2020; 271: 67-74
- Prophylactic negative-pressure wound therapy prevents surgical site infection in abdominal surgery: an updated systematic review and meta-analysis of randomized controlled trials and observational studies.Clin Infect Dis. 2021; 73: e3804-e3813
- Translation, cross-cultural adaptation and validation of the “Cardiff wound impact schedule,” a wound-specific quality of life instrument, to the native Spanish of Mexican patients.Int Wound J. 2020; 17: 167-173
- Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.Am J Infect Control. 1999; 27 (quiz 133–134; discussion 196): 97-132
- Surgical site infection in liver transplant recipients: impact of the type of perioperative prophylaxis.Transplantation. 2008; 85: 1849-1854
- Negative pressure wound therapy for surgical site infections: a systematic review and meta-analysis of randomized controlled trials.Clin Microbiol Infect. 2019; 25: 1328-1338
National Institute for Health and Care Excellence. Prevena incision management system for closed surgical incisions [Internet]. United Kingdom: National Institute for Health and Care Excellence (NICE); 2019 [cited 2022 Nov 15]. Available from: https://www.nice.org.uk/advice/mib173/chapter/The-technology
National Institute for Health and Care Excellence. PICO negative pressure wound dressings for closed surgical incisions [Internet]. United Kingdom: National Institute for Health and Care Excellence (NICE); 2019 [cited 2022 Nov 15]. Available from: https://www.nice.org.uk/guidance/mtg43
World Health Organization. Global guidelines for the prevention of surgical site infection. Suiza: World Health Organization (WHO); 2016. [cited 2022 Nov 15]. Available from: https://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf
- Predictors of surgical site infection after liver resection: a multicentre analysis using National Surgical Quality Improvement Program data.HPB (Oxford). 2012; 14: 136-141
- Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: an analysis of the epidemiology, risk factors, and outcomes.Liver Transpl. 2013; 19: 1011-1019
- Surgical site infections after liver retransplantation: incidence and risk factors.Liver Transpl. 2014; 20: 930-936
- Risk factors for development of surgical site infections among liver transplantation recipients: an integrative literature review.Am J Infect Control. 2018; 46: 88-93
- The role of closed incision negative pressure therapy in abdominal wall reconstruction: a current review of the evidence.Plast Reconstr Surg. 2018; 142: 156s-162s
- Negative pressure wound therapy for surgical wounds healing by primary closure.Cochrane Database Syst Rev. 2019; 3: Cd009261
- The impact of negative pressure wound therapy for closed surgical incisions on surgical site infection: a systematic review and meta-analysis.Surgery. 2020; 167: 1001-1009
- Prophylactic negative pressure wound therapy in colorectal surgery: effects on surgical site events: current status and call to action.Updates Surg. 2015; 67: 235-245
- Delayed wound healing with sirolimus after liver transplant.Ann Pharmacother. 2002; 36: 1391-1395
- Sirolimus as primary immunosuppression in liver transplantation is not associated with hepatic artery or wound complications.Liver Transpl. 2003; 9: 463-468
- A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications.Transplantation. 2004; 78: 264-268
- Quality of life and scar evolution after negative pressure or conventional therapy for wound dehiscence following post-bariatric abdominoplasty.Int Wound J. 2017; 14: 960-966
- A pilot study exploring quality of life experienced by patients undergoing negative-pressure wound therapy as part of their wound care treatment compared to patients receiving standard wound care.Int Wound J. 2014; 11: 357-365
- Negative pressure wound therapy versus standard wound care on quality of life: a systematic review.J Wound Care. 2016; 25: 156-159
Article info
Publication history
Published online: December 20, 2022
Accepted:
November 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
