Comparison of negative-pressure incision management system in wound dehiscence: A prospective, randomized, observational study

• Published in: Journal of medicine and life 2019-07, Vol.12 (3), p.276-283
• Main Authors: Gök, Mehmet Ali, Kafadar, Mehmet Tolga, Yeğen, Serkan Fatih
• Format: Article
• Language: English
• Subjects: Aged; Bandages; Body Mass Index; C-Reactive Protein - metabolism; Female; Humans; Length of Stay; Leukocyte Count; Male; Middle Aged; Negative-Pressure Wound Therapy; Original; Prospective Studies; Risk Factors; Surgical Wound Dehiscence - blood; Surgical Wound Dehiscence - complications; Surgical Wound Dehiscence - diagnosis; Surgical Wound Dehiscence - therapy
• ISSN: 1844-122X; 1844-3117
• DOI: 10.25122/jml-2019-0033

Wound dehiscence is a significant problem faced by surgeons after major abdominal surgery. In this study, it was aimed to select the best incision management system to keep the incision edges together and prevent wound opening, and infection by protecting the incision. In this study, 60 patients who underwent abdominal surgery were evaluated regarding their risk of wound dehiscence. In our clinic, high-risk cases of abdominal surgery are performed, the risk factors being ischemia along the incision line, dirty and contaminated wound, obesity, tension on the suture line, traumatization of the wound site, age at onset (> 65), body mass index (BMI) > 30, diabetes mellitus, chronic obstructive pulmonary disease (COPD), immunosuppressive drug users. A prospective study protocol was planned after ASA (American Society of Anesthesiologists) physical status class assignment. Patients were divided into three groups: patients who underwent a postoperative negative-pressure therapy dressing, patients who underwent subcutaneous aspiration drainage, and patients who received standard dressing. The aim of this study was to evaluate the decompensation, surgical site infection, seroma, hospital stay and costs and to evaluate the results in the postoperative period. Sixty patients were randomized (n = 20, for each group). Thirty-one (51%) of the patients were male, and the mean age was 64.3 ± 8.9 (46-85). The mean BMI was 30.45 ± 7.2. There was no statistically significant difference (p≥0.05) between groups in terms of sex, age, and BMI. The ASA score and surgical interventions were similar between the groups. Wound dehiscence rate was 25% (n = 8), 20% (n = 6) and 3% (n = 1) for the Standard Dressing (SD), Aspiration Drainage (AD) and Negative-Pressure (NP) groups, respectively (p