Novel wound management system reduction of surgical site morbidity after ventral hernia repairs: a critical analysis
Kevin C Soares1, Pablo A Baltodano1, Caitlin W Hicks1
1Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Background:
Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR.
Methods:
A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings. Multivariable logistic regression compared surgical site infections, surgical site occurrences, morbidity, and reoperation rates.
Results:
We evaluated 199 patients (115 HVAC vs 84 standard wound dressing patients). Mean follow-up was 9 months. The HVAC cohort had lower surgical site infections (9% vs 32%, P < .001) and surgical site occurrences (17% vs 42%, P = .001) rates. Rates of major morbidity (19% vs 31%, P = .04) and 90-day reoperation (5% vs 14%, P = .02) were lower in the HVAC cohort.
Conclusions:
The HVAC system is associated with optimized outcomes following open VHR. Prospective studies should validate these findings and define the economic implications of this intervention.
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