Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern.

Area of Science:

• Surgical Innovation
• Infectious Disease Prevention
• Pediatric Surgery

Background:

• Transumbilical laparoscopic-assisted appendectomy (TULAA) is associated with a high risk of surgical site infections (SSIs).
• Acute appendicitis management often involves minimally invasive techniques.
• Standard dressings may not adequately protect the umbilical wound in TULAA.

Purpose of the Study:

• To evaluate the efficacy of a bio-occlusive umbilical vacuum dressing in reducing SSIs after TULAA.
• To compare SSI rates between TULAA with vacuum dressing and conventional 3-port appendectomy.
• To assess the impact of negative-pressure wound therapy on umbilical wound healing in pediatric appendicitis.

Main Methods:

• Retrospective chart review of 1377 pediatric patients (2-20 years) undergoing laparoscopic appendectomy.
• Analysis of 1283 patients across 6 technique/dressing groups with over 50 participants each.
• Comparison of SSI rates between TULAA with vacuum dressing (dry gauze) and conventional dressings.

Main Results:

• TULAA with an umbilical vacuum dressing and dry gauze showed a low SSI rate of 1.8%.
• Conventional dry dressing without vacuum resulted in a higher SSI rate of 4.1%.
• Umbilical vacuum dressing with gauze and bacitracin had an SSI rate of 4.3%.

Conclusions:

• An umbilical negative-pressure dressing with dry gauze effectively lowers umbilical site infection rates in TULAA.
• This wound management strategy improves safety for pediatric patients undergoing TULAA for acute appendicitis.
• Negative-pressure wound therapy is a promising adjunct for reducing SSIs in minimally invasive umbilical surgery.