Four Curious Cases of Closed-Incision Negative Pressure Therapy (ciNPT)

Post-operative wound complications after infrainguinal vascular surgery can lead to a significant decrease in a patient's quality of life. The main complications are surgical site infection, wound dehiscence, seroma, hematoma, delayed healing and/or poor scarring. Closed-incision negative pressure therapy (ciNPT) in particular has recently been suggested as a method of prophylaxis against these surgical site complications when applied over a closed wound. In our unit, it has generally been used for long groin and abdominal surgical wounds. We describe here four relatively unusual cases of our experience using ciNPT. In our series, ciNPT has been used to good effect on small eccentrically shaped wounds and non-resolving groin hematomas. We have also used it in tandem with intra-cavity Vacuum Assisted Closure (VAC) (KCI, Acelity, San Antonio, TX) dressings for the management of partially closed wounds to reduce risk of infection and dehiscence. Additionally, it has shown good analgesic effects in our patient post-operatively. Hence, we suggest that the paradigm of ciNPT can be expanded to include these circumstances to improve wound healing and decrease risk of post-operative complications. Further research into the overall clinical benefits and cost-effectiveness will also be helpful.