The effect of negative pressure wound therapy on abdominal deep incisional surgical site infections in high-risk...

Surgical site infections (SSIs) significantly increase morbidity, mortality, and hospital stay, especially among high-risk patients with comorbidities such as diabetes or malignancy. Negative pressure wound therapy (NPWT) has improved outcomes in complex wounds, but its cost limits routine use in resource-constrained settings.

To evaluate the effectiveness of NPWT on infection resolution, morbidity, and mortality in high-risk and emergency surgery patients with abdominal deep incisional SSI.

High-risk patients (American Society of Anesthesiologists physical status class ≥III) who received NPWT for abdominal deep incisional SSI between February 1, 2015, and February 1, 2024, were analyzed. All cases met United States Centers for Disease Control and Prevention National Healthcare Safety Network criteria for deep SSI. NPWT was applied following infection control and surgical debridement. Dressings were changed on postoperative day 3 and every 5 days thereafter. Mean patient follow-up was 1 year.

Sixty-five patients (36 females, 29 males; mean [standard deviation] age, 58.7 [13.4] years) were included. Emergency surgery was the initial surgical procedure in 56.9% of cases, and malignancy was the primary surgical indication in 50.8% of all 65 cases. Diabetes was the most common comorbidity (47.7%). The overall mortality rate was 4.6%. No SSI recurrence was observed during mean 1-year follow-up.

NPWT is a safe and effective therapy for managing abdominal deep incisional SSIs in high-risk patients. In low-resource settings, its selective use in high-risk populations may optimize outcomes and cost-effectiveness.