Closed-wound negative pressure therapy dressing after loop ostomy closure: a retrospective comparative study.

Area of Science:

• Surgical Innovation
• Wound Management
• Infection Control

Background:

• Incisional surgical site infections (iSSI) are a complication after ostomy closure.
• Negative pressure wound therapy (NPWT) is a novel approach to reduce iSSI in high-risk surgical wounds.

Purpose of the Study:

• To compare iSSI rates in patients undergoing ostomy closure with and without NPWT.
• To evaluate the efficacy of closed-wound NPWT in preventing iSSI after ileo- or colostomy closure.

Main Methods:

• Retrospective analysis of 337 patients undergoing ostomy closure from January 2013 to January 2021.
• Patients received standard closure or closure with adjunctive NPWT (November 2018 onwards) for up to 5 days.
• iSSI rates were assessed within 30 days post-surgery, defined by CDC criteria.

Main Results:

• The study group (NPWT) had 4.7% iSSI rate compared to 10.7% in the control group (p=0.097).
• While not statistically significant, a trend towards reduced iSSI was observed with NPWT.
• Patient demographics and ostomy types were comparable, except for wound contamination class.

Conclusions:

• Systematic application of NPWT after loop ostomy closure may offer a potential benefit in reducing iSSI.
• Further investigation via a randomized controlled study is warranted to confirm these preliminary findings.