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Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery

Acosta, S. LU ; Björck, M. and Wanhainen, A. (2017) In British Journal of Surgery 104(2). p.75-84
Abstract

Background: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. Methods: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. Results: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent... (More)

Background: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. Methods: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. Results: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. Conclusion: NPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
104
issue
2
pages
75 - 84
publisher
John Wiley & Sons
external identifiers
  • scopus:85006482378
  • wos:000393594000009
ISSN
0007-1323
DOI
10.1002/bjs.10403
language
English
LU publication?
yes
id
9ce70796-25f7-4034-acb3-b63a6454f5de
date added to LUP
2017-01-19 09:40:01
date last changed
2018-04-15 04:39:58
@article{9ce70796-25f7-4034-acb3-b63a6454f5de,
  abstract     = {<p>Background: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. Methods: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. Results: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. Conclusion: NPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.</p>},
  author       = {Acosta, S. and Björck, M. and Wanhainen, A.},
  issn         = {0007-1323},
  language     = {eng},
  number       = {2},
  pages        = {75--84},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery},
  url          = {http://dx.doi.org/10.1002/bjs.10403},
  volume       = {104},
  year         = {2017},
}