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Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization – Rationale and design of a multi-center randomized controlled trial

Rezk, Francis LU orcid ; Åstrand, Håkan and Acosta, Stefan LU orcid (2019) In Contemporary Clinical Trials Communications 16.
Abstract

Introduction: Lower limb revascularization with inguinal incisions is a common vascular surgical procedure. Due to risk of injury to lymphatic vessels and a diverse bacterial flora in the groin, surgical site infections (SSI) represent a common and sometimes life-threatening complication. While transverse incisions in endovascular aneurysm repair has a low SSI rate, vertical incisions in thrombendarterectomy (TEA) has a higher risk and bypass the highest risk. This randomized controlled trial (RCT) will investigate the protective role of negative pressure wound therapy (NPWT) on closed inguinal incisions in elective vascular surgery undergoing TEA and bypass procedures, respectively, to prevent SSI. Methods: This RCT registered at... (More)

Introduction: Lower limb revascularization with inguinal incisions is a common vascular surgical procedure. Due to risk of injury to lymphatic vessels and a diverse bacterial flora in the groin, surgical site infections (SSI) represent a common and sometimes life-threatening complication. While transverse incisions in endovascular aneurysm repair has a low SSI rate, vertical incisions in thrombendarterectomy (TEA) has a higher risk and bypass the highest risk. This randomized controlled trial (RCT) will investigate the protective role of negative pressure wound therapy (NPWT) on closed inguinal incisions in elective vascular surgery undergoing TEA and bypass procedures, respectively, to prevent SSI. Methods: This RCT registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO™, Smith & Nephew, UK) to standard wound dressing on postoperative SSI. The multi-center study includes two distinct vascular procedures with different SSI risk profiles: TEA and lower limb bypass. Three hundred and fifty-eight groin incisions are anticipated to be included in the TEA group and 133 inguinal incisions in the bypass group. Bilateral inguinal incisions will be randomized to NPWT in one groin and control dressing in the contralateral groin, and this dependency was accounted for in sample size calculation and will be addressed in data analysis. Discussion: This RCT attempts to evaluate the potential benefit of NPWT on closed inguinal incisions after two distinct vascular procedures at high risk of SSI. Outcome of this trial could have implications on postoperative wound care in both vascular and non-vascular surgical patients.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bypass, Lower limb revascularization, Negative pressure wound therapy, Study protocol, Surgical site infection, Thrombendarterectomy
in
Contemporary Clinical Trials Communications
volume
16
article number
100469
publisher
Elsevier
external identifiers
  • pmid:31701043
  • scopus:85073924734
ISSN
2451-8654
DOI
10.1016/j.conctc.2019.100469
project
Prevention of surgical site infections after vascular surgery – multicenter randomized controlled trials
language
English
LU publication?
yes
id
f2d0d6d6-a79a-4bd1-a5e8-5db9f6c3e5f1
date added to LUP
2019-11-05 10:51:50
date last changed
2024-04-16 22:59:29
@article{f2d0d6d6-a79a-4bd1-a5e8-5db9f6c3e5f1,
  abstract     = {{<p>Introduction: Lower limb revascularization with inguinal incisions is a common vascular surgical procedure. Due to risk of injury to lymphatic vessels and a diverse bacterial flora in the groin, surgical site infections (SSI) represent a common and sometimes life-threatening complication. While transverse incisions in endovascular aneurysm repair has a low SSI rate, vertical incisions in thrombendarterectomy (TEA) has a higher risk and bypass the highest risk. This randomized controlled trial (RCT) will investigate the protective role of negative pressure wound therapy (NPWT) on closed inguinal incisions in elective vascular surgery undergoing TEA and bypass procedures, respectively, to prevent SSI. Methods: This RCT registered at ClinicalTrials.gov (Identifier: NCT01913132) compares the effects of a NPWT dressing (PICO™, Smith &amp; Nephew, UK) to standard wound dressing on postoperative SSI. The multi-center study includes two distinct vascular procedures with different SSI risk profiles: TEA and lower limb bypass. Three hundred and fifty-eight groin incisions are anticipated to be included in the TEA group and 133 inguinal incisions in the bypass group. Bilateral inguinal incisions will be randomized to NPWT in one groin and control dressing in the contralateral groin, and this dependency was accounted for in sample size calculation and will be addressed in data analysis. Discussion: This RCT attempts to evaluate the potential benefit of NPWT on closed inguinal incisions after two distinct vascular procedures at high risk of SSI. Outcome of this trial could have implications on postoperative wound care in both vascular and non-vascular surgical patients.</p>}},
  author       = {{Rezk, Francis and Åstrand, Håkan and Acosta, Stefan}},
  issn         = {{2451-8654}},
  keywords     = {{Bypass; Lower limb revascularization; Negative pressure wound therapy; Study protocol; Surgical site infection; Thrombendarterectomy}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Contemporary Clinical Trials Communications}},
  title        = {{Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization – Rationale and design of a multi-center randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1016/j.conctc.2019.100469}},
  doi          = {{10.1016/j.conctc.2019.100469}},
  volume       = {{16}},
  year         = {{2019}},
}