Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal

Background: The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a...

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Main Authors: Brian Williams, MD, Aubrey Swinford, MD, Jordan Martucci, MD, Johnny Wang, MD, Jordan R. Wlodarczyk, MD, Abhinav Gupta, MD, Kyle G. Cologne, MD, Sarah E. Koller, MD, Christine Hsieh, MD, Marjun P. Duldulao, MD, Joongho Shin, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Surgery Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589845025000028
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author Brian Williams, MD
Aubrey Swinford, MD
Jordan Martucci, MD
Johnny Wang, MD
Jordan R. Wlodarczyk, MD
Abhinav Gupta, MD
Kyle G. Cologne, MD
Sarah E. Koller, MD
Christine Hsieh, MD
Marjun P. Duldulao, MD
Joongho Shin, MD
author_facet Brian Williams, MD
Aubrey Swinford, MD
Jordan Martucci, MD
Johnny Wang, MD
Jordan R. Wlodarczyk, MD
Abhinav Gupta, MD
Kyle G. Cologne, MD
Sarah E. Koller, MD
Christine Hsieh, MD
Marjun P. Duldulao, MD
Joongho Shin, MD
author_sort Brian Williams, MD
collection DOAJ
description Background: The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods. Methods: This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported. Results: Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days. Conclusion: Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.
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spelling doaj-art-5a4b6d83c0dd42d28b17d3ace2e282b52025-01-31T05:12:17ZengElsevierSurgery Open Science2589-84502025-01-01236974Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversalBrian Williams, MD0Aubrey Swinford, MD1Jordan Martucci, MD2Johnny Wang, MD3Jordan R. Wlodarczyk, MD4Abhinav Gupta, MD5Kyle G. Cologne, MD6Sarah E. Koller, MD7Christine Hsieh, MD8Marjun P. Duldulao, MD9Joongho Shin, MD10Keck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USA; Corresponding author at: Department of Surgery, Division of Colorectal Surgery, Keck Medicine of USC, 1441 Eastlake Avenue Suite 7418, Los Angeles, CA 90033, USA.Keck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck School of Medicine of USC, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USALos Angeles General Medical Center, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USAKeck Medicine of USC, Division of Colorectal Surgery, Los Angeles, CA, USABackground: The use of closed-incision negative pressure wound therapy (ci-NPWT) has been shown to reduce postoperative wound complications and surgical site infections (SSI) after stoma closures. However, use of this approach has not been widely adopted due to high cost of the devices. We present a novel approach to stoma closure in which a self-contained mechanically powered negative pressure dressing (MP-NPD) is applied to primarily closed stoma reversal wounds. We hypothesized that SSI and wound complication rates would be improved compared to traditional stoma closure methods. Methods: This was a prospective investigator-initiated study, in which consecutive patients that underwent stoma reversal with primary stoma wound closure dressed with MP-NPD from May 2021–March 2022. 30-day outcomes from the study group, including surgical site infection, other wound complications, hospital length of stay (LOS), and readmission rates, were then reported. Results: Forty-six patients undergoing local ileostomy or colostomy closure were identified for the study group. Patient demographics and surgical variables were reported. One (2.2 %) patient in the study cohort developed superficial SSI within 30 days of their surgery. Post-op LOS in the study group versus was 4.1 days. Conclusion: Intestinal stoma reversal wounds closed primarily and dressed with the MP-NPD dressings had very low stoma site SSI rates. These results are promising as they pertain to the use of MP-NPD in stoma reversal procedures, however further large prospective RCTs with a matched control group could help better corroborate these findings.http://www.sciencedirect.com/science/article/pii/S2589845025000028Negative pressure dressingClosed-incision negative pressure wound therapySurgical site infectionWound healingColorectalIleostomy closure
spellingShingle Brian Williams, MD
Aubrey Swinford, MD
Jordan Martucci, MD
Johnny Wang, MD
Jordan R. Wlodarczyk, MD
Abhinav Gupta, MD
Kyle G. Cologne, MD
Sarah E. Koller, MD
Christine Hsieh, MD
Marjun P. Duldulao, MD
Joongho Shin, MD
Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
Surgery Open Science
Negative pressure dressing
Closed-incision negative pressure wound therapy
Surgical site infection
Wound healing
Colorectal
Ileostomy closure
title Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
title_full Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
title_fullStr Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
title_full_unstemmed Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
title_short Mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
title_sort mechanically powered negative pressure dressing reduces surgical site infection after stoma reversal
topic Negative pressure dressing
Closed-incision negative pressure wound therapy
Surgical site infection
Wound healing
Colorectal
Ileostomy closure
url http://www.sciencedirect.com/science/article/pii/S2589845025000028
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