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Published on: May 2, 2025
Efficacy of Prophylactic Negative Pressure Wound Therapy After Pediatric Liver Transplant
Genshiro Esumi1, Toshiharu Matsuura, Makoto Hayashida
1From the Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Insights
Negative pressure wound therapy effectively prevents surgical site complications in pediatric liver transplant patients. This approach significantly reduced wound dehiscence compared to conventional methods.
Area of Science:
- Surgical complications
- Transplantation
- Wound healing
Background:
- Wound dehiscence is a frequent surgical complication in pediatric liver transplant recipients.
- Negative pressure wound therapy (NPWT) was implemented in 2013 to prevent such complications.
Purpose of the Study:
- To evaluate the clinical outcomes of prophylactic NPWT in pediatric liver transplant recipients.
- To compare the incidence of surgical complications between conventional wound management and NPWT.
Main Methods:
- Retrospective review of 25 pediatric liver transplant recipients.
- Patients were divided into a conventional wound management group (n=13) and a prophylactic NPWT group (n=12).
- Comparison of surgical complication rates and patient characteristics between the two groups.
Main Results:
- Wound dehiscence occurred in 7/13 patients (conventional group) vs. 3/12 patients (prophylactic group).
- Surgical debridement for dehiscence was required in 6/13 patients (conventional group) vs. 0/12 patients (prophylactic group).
- The prophylactic NPWT group showed a significantly lower incidence of wound dehiscence (P = .015), despite having more severe liver insufficiency.
Conclusions:
- Prophylactic negative pressure wound therapy is effective in preventing wound dehiscence in pediatric liver transplant recipients.
- NPWT offers a promising strategy to reduce surgical site complications in this vulnerable patient population.
Objectives:
Wound dehiscence is a common surgical complication, especially among pediatric liver transplant recipients in our center. In 2013, we introduced negative pressure wound therapy as a preventive treatment. We herein report the clinical outcomes of this intervention.
Materials And Methods:
We conducted a retrospective review of the 26 pediatric liver transplant recipients in our center since 2011. We excluded 1 girl whose wound could not be closed due to bowel edema. The first 13 of the 25 remaining patients were treated with conventional wound management (conventional group). The latter 12 were treated with prophylactic negative pressure wound therapy (prophylactic group). Incidences of surgical complications and patient characteristics were compared between groups.
Results:
Wound dehiscence occurred in 7 of the 13 patients in the conventional group and 3 of the 12 patients in the prophylactic group. When restricted to dehiscence that required surgical debridement, there were 6 cases in the conventional group and no cases in the prophylactic group. Although background data showed that liver insufficiency in the prophylactic group was more severe, this group had a lower incidence of wound dehiscence (P = .015).
Conclusions:
Prophylactic negative pressure wound therapy is thought to be effective for preventing wound dehiscence among pediatric liver transplant recipients.
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