Abstract

Objectives: Post-operative wound complications, including surgical site infections (SSI), are a major cause of morbidity. Noninvasive negative pressure wound therapy (NNPWT) has been investigated as a tool to decrease wound complications. Here, we evaluate effect of NNPWT on overweight and obese patients undergoing major abdominal surgery via vertical midline laparotomy, performed by a gynecologic oncologist.
Methods: We conducted a multi-center retrospective review of overweight (BMI 25.0-29.9 kg/m²) and obese (BMI >30kg/m²) patients undergoing surgery via vertical midline laparotomy by a gynecologic oncologist. Key exclusion criteria included; patients with a BMI <25 kgm² and surgery performed by incision other than midline vertical incision. We compared the 30-day SSI rate, 30-day hospital readmission rates and length of hospital stay (LOS) between patients receiving NNPWT versus those receiving traditional wound dressing.
Results: Final analysis included 192 patients; 155 (80.7%) patients received a traditional wound dressing (pre-intervention) and 37 (19.3%) received NNPWT (post-intervention). The mean BMI was 32.1kg/m² (25.0-58.0). The use of NNPWT was associated with a significant decrease in SSI compared to traditional wound dressing (0% vs.9.6%; p<0.001). NNPWT was also associated with a significant decrease in LOS (5.6 days vs. 9 days; p=0.001) and fascial dehiscence (0% vs. 3.75%; p=0.025).
Conclusion: NNPWT significantly decreased the SSI rate and hospital LOS in overweight and obese patients undergoing major gynecologic surgery via vertical midline laparotomy.