Beniwal Abhijeet, Karwasra Isha
Colorectal Surgery, St. Mark's Hospital at Central Middlesex Hospital, London, GBR.
Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, GBR.
Cureus. 2025 Jan 7;17(1):e77103. doi: 10.7759/cureus.77103. eCollection 2025 Jan.
Surgical site infections (SSIs) are a significant concern in colorectal surgery, impacting patient outcomes and increasing treatment costs. The study investigates the effect of PICO 7 (Smith & Nephew) dressings, a negative pressure wound therapy (NPWT) system, on the incidence of SSIs in high-risk patients undergoing elective colorectal resections and emergency laparotomies.
This retrospective cohort study was conducted at the Colorectal Surgery Unit at Russell's Hall Hospital, Dudley, United Kingdom. The cohort included patients who underwent open colorectal resections and emergency laparotomies with PICO 7 dressing following laparotomy wound closure. The primary endpoint was the incidence of SSI within 30 days of surgery. Secondary endpoints included length of hospital stay, frequency of readmissions, episodes of return to theatre, and interventions such as radiological or open drainage of the abscess. Data were compared with existing literature, given the plan was originally to compare outcomes with a cohort managed with conventional dressings.
A total of 27 cases were reviewed where PICO 7 was applied. Of these, 21 were emergency laparotomies, 11 patients had a stoma created, and 16 had abdominal cavity contamination (faecal matter, pus, serous collection). The majority (14 patients) had a body mass index (BMI) >30, and 16 patients had an American Society of Anesthesiologists (ASA) grade 3. Out of these, eight (30%) developed SSIs, including overlaps of dehiscence and deep space infection. The average hospital stay was 17 days, with one patient readmitted with SSI and four requiring interventions such as return to theatre or radiological drainage.
The study found a higher incidence of SSIs (30%) compared to existing literature, despite using NPWT. Contributing factors included perforated viscus, high BMI, multiple comorbidities, and stoma creation. A larger study cohort with a control group is necessary for further evaluation.
手术部位感染（SSIs）是结直肠手术中的一个重大问题，影响患者预后并增加治疗成本。本研究调查了PICO 7（施乐辉公司）敷料（一种负压伤口治疗（NPWT）系统）对接受择期结直肠切除术和急诊剖腹手术的高危患者手术部位感染发生率的影响。
这项回顾性队列研究在英国达德利拉塞尔霍尔医院的结直肠外科进行。该队列包括接受开放性结直肠切除术和急诊剖腹手术且在剖腹伤口闭合后使用PICO 7敷料的患者。主要终点是术后30天内手术部位感染的发生率。次要终点包括住院时间、再次入院频率、返回手术室的次数以及诸如脓肿的放射学或开放引流等干预措施。鉴于最初计划是将结果与使用传统敷料管理的队列进行比较，因此将数据与现有文献进行了比较。
共审查了27例应用PICO 7的病例。其中，21例为急诊剖腹手术，11例患者造口，16例有腹腔污染（粪便、脓液、浆液性积液）。大多数（14例患者）体重指数（BMI）>30，16例患者美国麻醉医师协会（ASA）分级为3级。其中，8例（30%）发生手术部位感染，包括切口裂开和深部间隙感染的重叠。平均住院时间为17天，1例患者因手术部位感染再次入院，4例需要诸如返回手术室或放射学引流等干预措施。
该研究发现，尽管使用了负压伤口治疗，但与现有文献相比，手术部位感染的发生率更高（30%）。促成因素包括脏器穿孔、高BMI、多种合并症和造口。需要更大的研究队列和对照组进行进一步评估。
