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Postoperative negative-pressure incision therapy after liver transplant (PONILITRANS study): A randomized controlled trial

  • Victor Lopez-Lopez
    Correspondence
    Reprint requests: Victor Lopez-Lopez, MD, PhD, Department of General, Visceral, and Transplantation Surgery, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120, El Palmar, Murcia, Spain.
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Alberto Hiciano-Guillermo
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Laura Martinez-Alarcon
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Ana Delegido
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Felipe Alconchel
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Jose Antonio Pons
    Affiliations
    Department of Hepatology, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain
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  • Juan Ángel Fernández
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Antonio Ríos
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • José Manuel Rodríguez
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Kohei Miura
    Affiliations
    Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan
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  • Francisco Sánchez-Bueno
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Ricardo Robles-Campos
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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  • Pablo Ramírez
    Affiliations
    Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain

    Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
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Published:December 20, 2022DOI:https://doi.org/10.1016/j.surg.2022.11.011

      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

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