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LINK Scientific Content – Congress Abstract

Prophylactic ciNPWT for high-risk laparotomy wounds. Preliminary results of a multi-centre randomised controlled trial

Scientific Content

Prophylactic ciNPWT for high-risk laparotomy wounds. Preliminary results of a multi-centre randomised controlled trial

Type
Congress Abstract
Topics
LINK Congress 2019, NPWT
Language
EN
Publication Year
2019
Author(s)
B. Banky, M. Durci, A. Fülöp, G. Ferreira
Approx. reading time
5 min

Aim

Emergency laparotomy wounds represent a high risk condition for surgical site infection (SSI) due to the amount and quality of peritoneal and abdominal wall exudate production.

Closed incisional negative pressure wound therapy (ciNPWT) is one of the potential tools to control excessive exudate production and prevent SSI. The aim of our trial was to assess the effectiveness of ciNPWT in the prevention of SSI. In order to achieve a sufficient power of the study, we conducted a multicentric, ethically approved RCT spanning 12 abdominal surgery centres.

Methods

300 cases of Class III-IV. Wound-type emergency laparotomies were randomized with 1:1 ratio into conventional, dry wound care and ciNPWT treatment for 5 postoperative days. Primary endpoint of the trial was SSI requiring wound re-opening with removal of wound stitches or clips. Secondary endpoint was abdominal wall dehiscence requiring surgical re-intervention.

Results

10 surgical centres of the 12 accredited departments have started to recruit suitable candidates for the trial. In frame of the presentation we are ready to present the interim analysis results of the first 100 cases.

Conclusion

We aim to demonstrate (prove or rule out) the clinical effectiveness of ciNPWT in septic laparotomy surgery. We are awaiting firm responses on critical morbidity and financial questions regarding the technique, which remained open in the literature, so far.

Clinical relevance

ciNPWT may step up into primary choice in septic laparotomy for SSI prevention if clinical superiority and cost effectiveness can be demonstrated in a high qualitymulticentric RCT.

Acknowledgements

This presentation represents the cooperation of 10 institutions: Krisztina Varga, András Fülöp, Gábor Ferreira, László Harsányi, László Ternyik, Zsolt Káposztás, Zsolt Susán, Zsolt Szentkereszty, Zsolt Simonka, György Lázár, Balázs Mohos, Zoltán Lóderer, László Venczel, László Sikorszki, Éva Lilla Kovács, Zsolt Kincses, Balázs Samu Pánczél, Vilmos Szendrényi.

Authors

Balazs Banky
St. Borbala Hospital, Department of Surgery, Tatabanya, Hungary

Mihály Durci
St. Borbala Hospital, Department of Surgery, Tatabanya, Hungary

Andràs Fülöp
Semmelweis University, 1st Department of Surgery, Budapest, Hungary

Gàbor Ferreira
Semmelweis University, 1st Department of Surgery, Budapest, Hungary

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