Postoperative negative-pressure incision therapy after liver transplant (PONILITRANS study): A randomized controlled trial.


Journal

Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347

Informations de publication

Date de publication:
04 2023
Historique:
received: 26 07 2022
revised: 08 11 2022
accepted: 13 11 2022
pubmed: 23 12 2022
medline: 15 3 2023
entrez: 22 12 2022
Statut: ppublish

Résumé

Postoperative complications of surgical incisions are frequent in liver transplantation. However, evidence justifying the use of incisional negative pressure wound therapy to improve surgical wound outcomes remains limited. Participating patients were randomly assigned to receive incisional negative pressure wound therapy or standard surgical dressing on the closed surgical incision of the liver transplantation. The primary endpoint was surgical site infection incidence 30 days postoperatively. The secondary endpoints included surgical site events (ie, surgical site infection, dehiscence, hematoma, and seroma) and wound quality of life. Between December 2018 and September 2021, 108 patients (54 in the incisional negative pressure wound therapy group and 54 in the control group) were enrolled in this study. The incidence of surgical site infection at 30 days postoperatively was 7.4% in the treatment group and 13% in the control group (P = .34). The rate of surgical site events was similar in the treatment in the and control group (27.8% vs 29.6%, P = .83). In relation to wound quality of life, the mean score was 75.20 ± 7.27 in the incisional negative pressure wound therapy group and 72.82 ± 10.57 in the control group (P = .23). The prophylactic use of negative pressure wound therapy on primarily closed incisions did not significantly reduce incisional surgical site infection and surgical site event rates after liver transplantation compared with standard surgical dressings.

Sections du résumé

BACKGROUND
Postoperative complications of surgical incisions are frequent in liver transplantation. However, evidence justifying the use of incisional negative pressure wound therapy to improve surgical wound outcomes remains limited.
METHODS
Participating patients were randomly assigned to receive incisional negative pressure wound therapy or standard surgical dressing on the closed surgical incision of the liver transplantation. The primary endpoint was surgical site infection incidence 30 days postoperatively. The secondary endpoints included surgical site events (ie, surgical site infection, dehiscence, hematoma, and seroma) and wound quality of life.
RESULTS
Between December 2018 and September 2021, 108 patients (54 in the incisional negative pressure wound therapy group and 54 in the control group) were enrolled in this study. The incidence of surgical site infection at 30 days postoperatively was 7.4% in the treatment group and 13% in the control group (P = .34). The rate of surgical site events was similar in the treatment in the and control group (27.8% vs 29.6%, P = .83). In relation to wound quality of life, the mean score was 75.20 ± 7.27 in the incisional negative pressure wound therapy group and 72.82 ± 10.57 in the control group (P = .23).
CONCLUSION
The prophylactic use of negative pressure wound therapy on primarily closed incisions did not significantly reduce incisional surgical site infection and surgical site event rates after liver transplantation compared with standard surgical dressings.

Identifiants

pubmed: 36549975
pii: S0039-6060(22)00963-1
doi: 10.1016/j.surg.2022.11.011
pii:
doi:

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1072-1078

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Victor Lopez-Lopez (V)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain. Electronic address: victorrelopez@gmail.com.

Alberto Hiciano-Guillermo (A)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Laura Martinez-Alarcon (L)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Ana Delegido (A)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Felipe Alconchel (F)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Jose Antonio Pons (JA)

Department of Hepatology, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain.

Juan Ángel Fernández (JÁ)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Antonio Ríos (A)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

José Manuel Rodríguez (JM)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Kohei Miura (K)

Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan.

Francisco Sánchez-Bueno (F)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Ricardo Robles-Campos (R)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.

Pablo Ramírez (P)

Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain. Electronic address: https://twitter.com/ramirez_cirugia.

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