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Inguinal Vascular Surgical Wound Protection by Incisional Negative Pressure Wound Therapy : A Randomized Controlled Trial-INVIPS Trial

Hasselmann, Julien LU ; Björk, Jonas LU ; Svensson-Björk, Robert LU and Acosta, Stefan LU (2020) In Annals of Surgery 271(1). p.48-53
Abstract

OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions... (More)

OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions received either NPWT or a standard dressing. Patients with bilateral incisions randomly received a dressing on one incision and the opposite dressing on the other. The primary endpoints were SSI or other wound complications at 3 months, assessed by wound care experts blinded to the treatment arm and using objective wound assessment criteria (ASEPSIS-score). Statistical analysis was performed on an intention-to-treat basis and obtained P values from analyses in the uni- and bilateral groups were combined to an overall P value using Fisher's method for combining P values. RESULTS: The incidence of SSI was reduced in the NPWT group compared with the control group [11.9% vs 29.5% in the unilateral group (n = 120), 5.3% vs 26.3% in the bilateral group (n = 19), respectively; combined P = 0.02]. No differences regarding other surgical site complications were observed between the groups. CONCLUSION: NPWT on closed inguinal vascular surgical incisions in elective patients reduces the incidence of SSI.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgery
volume
271
issue
1
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:31283565
  • scopus:85077107432
ISSN
1528-1140
DOI
10.1097/SLA.0000000000003364
language
English
LU publication?
yes
id
c92afacb-0f3b-47f8-bd24-002fd84122d9
date added to LUP
2020-01-10 11:05:19
date last changed
2020-01-16 04:09:06
@article{c92afacb-0f3b-47f8-bd24-002fd84122d9,
  abstract     = {<p>OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions received either NPWT or a standard dressing. Patients with bilateral incisions randomly received a dressing on one incision and the opposite dressing on the other. The primary endpoints were SSI or other wound complications at 3 months, assessed by wound care experts blinded to the treatment arm and using objective wound assessment criteria (ASEPSIS-score). Statistical analysis was performed on an intention-to-treat basis and obtained P values from analyses in the uni- and bilateral groups were combined to an overall P value using Fisher's method for combining P values. RESULTS: The incidence of SSI was reduced in the NPWT group compared with the control group [11.9% vs 29.5% in the unilateral group (n = 120), 5.3% vs 26.3% in the bilateral group (n = 19), respectively; combined P = 0.02]. No differences regarding other surgical site complications were observed between the groups. CONCLUSION: NPWT on closed inguinal vascular surgical incisions in elective patients reduces the incidence of SSI.</p>},
  author       = {Hasselmann, Julien and Björk, Jonas and Svensson-Björk, Robert and Acosta, Stefan},
  issn         = {1528-1140},
  language     = {eng},
  number       = {1},
  pages        = {48--53},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Annals of Surgery},
  title        = {Inguinal Vascular Surgical Wound Protection by Incisional Negative Pressure Wound Therapy : A Randomized Controlled Trial-INVIPS Trial},
  url          = {http://dx.doi.org/10.1097/SLA.0000000000003364},
  doi          = {10.1097/SLA.0000000000003364},
  volume       = {271},
  year         = {2020},
}