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Prophylactic Negative Pressure Wound Therapy After Laparotomy for Gynecologic Surgery: A Randomized Controlled Trial.

Mario M Leitao1, Qin C Zhou, Maria B Schiavone

  • 1Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, the Department of Obstetrics and Gynecology, Weill Cornell Medical College, and the Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York; the Division of Gynecologic Oncology, Hartford Healthcare Cancer Institute, Hartford, Connecticut; the Lehigh Valley Cancer Institute, Allentown, Pennsylvania; and the Miami Cancer Institute, Miami, Florida.

Obstetrics and Gynecology
|January 8, 2021
PubMed
Summary

Negative pressure wound therapy (NPWT) did not reduce wound complications after gynecologic laparotomy. The study found NPWT increased skin blistering compared to standard gauze, suggesting it is not effective for this patient group.

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Area of Science:

  • Gynecologic Surgery
  • Wound Management
  • Clinical Trials

Background:

  • Laparotomy for gynecologic surgery can lead to wound complications.
  • Prophylactic negative pressure wound therapy (NPWT) is a potential intervention to reduce these complications.

Purpose of the Study:

  • To evaluate the effectiveness of prophylactic negative pressure wound therapy (NPWT) in preventing wound complications following laparotomy for gynecologic surgery.

Main Methods:

  • A randomized controlled trial was conducted with patients undergoing laparotomy for presumed gynecologic malignancy.
  • Patients were randomized to receive either standard gauze or negative pressure wound therapy (NPWT) after skin closure.
  • The primary outcome was the rate of wound complications within 30 days.

Main Results:

  • The study was stopped early for futility. Wound complication rates were similar between NPWT (17.3%) and gauze (16.3%) groups.
  • Negative pressure wound therapy (NPWT) was associated with a significantly higher incidence of skin blistering (13% vs 1.2%).
  • No significant difference in overall wound complication rates was observed between the two groups.

Conclusions:

  • Negative pressure wound therapy (NPWT) is not effective in reducing wound complications after laparotomy for gynecologic surgery.
  • NPWT use in this context is associated with an increased risk of skin blistering.
  • Standard gauze appears to be a suitable alternative for wound management in this patient population.