Department of Vascular Surgery, Fiona Stanley Hospital, Perth, WA, Australia.
Department of General Surgery, Sir Charles Gardiner Hospital, Nedlands, WA, Australia.
Vascular. 2023 Dec;31(6):1128-1133. doi: 10.1177/17085381221111007. Epub 2022 Jun 27.
Surgical site infection (SSI) is a common complication in vascular surgery, and is associated with increased patient morbidity, readmission and reintervention. The aim of this study was to assess the impact of closed-incision negative pressure wound therapy (CiNPWT) upon rate of SSI and length of hospital stay.
This study was reported in line with the STROBE guidelines. We assessed the baseline incidence of SSI from a 12-month retrospective cohort and, following a change in practice intervention with CiNPWT, compared to a 6-month prospective cohort. The primary endpoint was incidence of SSI (according to CDC-NHSN guidelines) while secondary endpoints included length of hospital stay, readmission, reintervention and Days Alive and Out of Hospital (DAOH) to 90-days.
A total of 127 groin incisions were performed: 76 (65 patients) within the retrospective analysis and 51 (42 patients) within the prospective analysis (of whom 69% received CiNPWT). The primary endpoint of SSI was seen in 21.1% of the retrospective cohort and 9.8% of the prospective cohort ( = .099). Readmission was found to be significantly associated with the retrospective cohort ( = .016) while total admission (inclusive of re-admission) was significantly longer in those in the retrospective cohort ( = .013). DAOH-90 was 83 days (77-85) following introduction of the CiNPWT protocol as compared to the retrospective cohort (77 days (64-83), = .04).
Introduction of CiNPWT was associated with a reduced length of hospital stay and improved DAOH-90. Further trials on CINPWT should include patient-centred outcomes and healthcare cost analysis.
手术部位感染(SSI)是血管外科的常见并发症,与患者发病率增加、再入院和再干预有关。本研究旨在评估闭合切口负压伤口治疗(CiNPWT)对 SSI 发生率和住院时间的影响。
本研究按照 STROBE 指南进行报告。我们评估了为期 12 个月的回顾性队列中 SSI 的基线发生率,并在 CiNPWT 实践干预后,与为期 6 个月的前瞻性队列进行了比较。主要终点是 SSI 的发生率(根据 CDC-NHSN 指南),次要终点包括住院时间、再入院、再干预和 90 天内的存活和离院天数(DAOH)。
共进行了 127 例腹股沟切口:76 例(65 例患者)在回顾性分析中,51 例(42 例患者)在前瞻性分析中(其中 69%接受 CiNPWT)。回顾性队列的主要终点 SSI 发生率为 21.1%,前瞻性队列为 9.8%( =.099)。再入院与回顾性队列显著相关( =.016),而回顾性队列的总入院时间(包括再入院)明显更长( =.013)。引入 CiNPWT 方案后,90 天的 DAOH 为 83 天(77-85),而回顾性队列为 77 天(64-83)( =.04)。
引入 CiNPWT 与缩短住院时间和改善 90 天 DAOH 相关。关于 CINPWT 的进一步试验应包括以患者为中心的结局和医疗保健成本分析。