Closed Incision Negative Pressure Therapy: Indications and Adherence to Protocol

Area of Science:

• Surgical innovation
• Wound healing research
• Clinical practice guidelines

Background:

• Wound management complications increase morbidity, mortality, and healthcare costs.
• Closed incision negative pressure therapy (CINPT) offers a potential improvement over traditional methods.
• Current Food and Drug Administration (FDA) indications for CINPT are broad, raising questions about patient selection.

Purpose of the Study:

• To identify common clinical indications for CINPT.
• To establish a consensus on appropriate candidates for CINPT.
• To determine if patient demographics influence CINPT decision-making.

Main Methods:

• A comprehensive literature review of 57 articles was performed.
• The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was utilized.
• Data from over 11,000 patients receiving CINPT were analyzed.

Main Results:

• Obesity (BMI >30), smoking, and diabetes mellitus were consistently identified as primary indications for CINPT.
• Obesity was noted in 47.1% (NSQIP) and 39.6% (literature) of patients.
• Diabetes mellitus was present in 22.7% (NSQIP) and 47.9% (literature) of patients.

Conclusions:

• High BMI, smoking, and diabetes mellitus are the most frequent indications for CINPT.
• These findings aid in identifying patients most likely to benefit from CINPT.
• The study supports adherence to literature-based practice guidelines for CINPT in wound management.