Assessing The Benefit Of Incisional Negative Pressure Dressing In Vascular Patients With Infrainguinal Incisions
Laura Meiler, DO1, Bhakti Chavan2, Chase Beach, DO3, Dwayne North, DO1, Jeffrey Stanley, DO1, Nicole Ramon, DO1.
1South Pointe Hospital, Warrensville Heights, OH, USA, 2Ohio Universtiy, Athens, OH, USA, 3Western Reserve Hospital, Cuyahoga Falls, OH, USA.
OBJECTIVES: Within the vascular patient population there is increased risk of developing wound complications especially in infra-inguinal incisions. There has been increasing interest in using closed incisional negative pressure dressings to decrease the risk of wound complications. To assess the efficacy of these incisional wound dressings we studied surgical site infections and seroma rates of infrainguinal incisions in our vascular patient population.
METHODS: This was a multi-institutional, retrospective study from July 2015- June 2019. In 2017 our institution began using the Prevena incisional wound system. Wound complication rates were compared to the non Prevena group prior to 2017. There was a total of 100 infrainguinal incisions (left and right combined) that received the Prevena wound system and 138 infrainguinal incisions that had not. The primary endpoint was to assess for wound complication rates including surgical site infections and seroma formation. Surgical site infections were graded based on the ACS-NSQIP SSI criteria . Seroma formation was diagnosed based on clinical diagnosis, imaging studies (ultrasound, CT) or needle aspiration of fluid collection.
RESULTS: Analysis showed a statistically significant decrease in the rate of SSIs in the Prevena group when compared to the non Prevena group. Of the 100 incisions that received the Prevena wound system 1.2% (1/82) had a femoral SSI and 22% (4/18) had a popliteal SSI. For seroma formation 24.4% (20/82) had a femoral seroma and 11.1% (2/18) had a popliteal seroma. Of the 138 incisions that did not have the Prevena wound system, 9.6% (10/104) had a femoral SSI, and 22.2% (4/18) had a popliteal SSI. For seroma formation 24.0% (25/104) had a femoral seroma and 8.8%(3/34) had a popliteal seroma. Comorbid conditions were assessed in the two study groups and there was no statistical significance regarding rates of surgical site infections between the groups.
CONCLUSIONS: The use of an incisional negative pressure dressing decreases the rate of surgical site infections in infrainguinal incisions. Regarding the use of these wound systems for seromas; our study did not show a statistical significance in decreasing seroma rates.
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