Wound Management System Reduces Surgical Site Morbidity

A new study demonstrates that prophylactic incisional negative pressure wound therapy (NPWT) is effective following ventral hernia repairs (VHR).

Researchers at the Johns Hopkins University (JHU; Baltimore, MD, USA) conducted a five-year retrospective analysis of all VHRs performed by a single surgeon at JHU, and compared the outcomes and impact of using a modified NPWT system with vacuum assisted closure (Hybrid-VAC), as compared to standard wound dressings (SWD). Study outcomes included surgical site infections (SSIs), surgical site occurrences (SSOs), morbidity, and reoperation rates.

In all, the researchers evaluated 199 patients (115 Hybrid-VAC versus 84 SWD patients), with a mean follow up period of nine months. The Hybrid-VAC cohort had lower SSI (9%) and SSO (17%), when compared to SWD (32% and 42%), respectively. The rates of major morbidity were also lower (19% compared to 31%), as were 90-day reoperation (5% compared to 14%) in the Hybrid-VAC cohort. The study was published on August 6, 2014, in the American Journal of Surgery.

“The Hybrid-VAC system is associated with optimized outcomes following open VHR,” concluded lead author Kevin Soares, MD, and colleagues of the department of surgery. “Prospective studies should validate these findings and define the economic implications of this intervention.”

NPWT VAC is the controlled application of subatmospheric pressure to a wound using intermittent or continuous negative pressure to a specialized wound dressing to help promote wound healing. The wound dressing is comprised of a resilient, open-cell foam surface dressing that assists tissue granulation, and is sealed with an adhesive drape that contains the subatmospheric pressure at the wound site. Patient safety is maintained by regulating pressure at the wound site. VAC therapy also helps direct drainage to a specially designed canister that reduces the risk of exposure to exudate fluids and infectious materials.

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