Use of prophylactic closed-incision negative-pressure therapy (CINPT) is associated with reduced surgical-site infections in patients undergoing open abdominal surgeries during the Covid-19 pandemic

Faculty Medicine Year: 2022
Type of Publication: ZU Hosted Pages:
Authors:
Journal: The Egyptian Journal of Surgery Wolters Kluwer - Medknow Volume:
Keywords : , , prophylactic closed-incision negative-pressure therapy (CINPT) , associated with    
Abstract:
Background Surgical-site infections (SSIs) are found to occur after about 2–5% of all surgeries. SSIs have many drawbacks such as the need for readmission, revision operations, prolonged duration of hospital stay, increased financial burden on patients and increased risk of worsening outcome in cancer patients. Closed-incision negativepressure therapy (CINPT) was studied as a method of preventing infections in wounds occurring after closed surgical incisions particularly during the covid-19 pandemic. There are many studies showed promising results of this procedure. Therefore, in this prospective clinical randomized study, we aimed to evaluate the benefit of performing prophylactic CINPT in controlling SSIs in open colorectal surgeries, hepatobiliary surgeries and gynecological cancer surgeries involving laparotomies, in comparison with the standard dressings. Patients and method We included 120 patients of SSIs with open colorectal surgeries, hepatobiliary surgeries and gynecological cancer surgeries involving laparotomies in the period between 2015 and 2020. We divided the patients randomly into two groups: the first group is the study group, which included 30 patients managed by CINPT, and the second group is the control group, which included 90 patients managed by standard non-CINPT management. We compared patients who underwent CINPT with the control group of high-risk patients undergoing routine management non- CINPT procedures. Results The median rate of occurrence of general adversewound outcomeswas 32.5%for all the included patients: 20% in the CINPT group and 36.7% in the control group (P =0.049). The median rate of occurrence of SSIs was 17.5% for all the included patients: 7% in the CINPT group and 15% in the control group (P=0.001). Time to diagnose SSIs in the CINPT group was longer than that in the control group (19 vs 13 days;P=0.03). The increased duration of operation and the presence of preoperative or postoperative stoma were associated with increased incidence of occurrence of SSI, while CINPT was associated with decreased incidence of occurrence of SSIs (P<0.001). Conclusion We observed a marked reduction in the rates of SSIs in closed laparotomy wounds in colorectal, hepato-pancreato-biliary and in gynecological oncology surgeries managed with prophylactic CINPT particularly during the Covid-19 pandemic.
   
     
 
       

Author Related Publications

  • Adel Mahmoud Attia Attia Morsi, "Sleeve Gastrectomy and Cholecystectomy are Safe in Obese Patients with Asymptomatic Cholelithiasis. A Multicenter Randomized Trial", Springer, 2022 More
  • Adel Mahmoud Attia Attia Morsi, "Optimizing peri-operative feeding to decrease post-operative stress response in patients with colo-rectal cancer.", Zagazig University faculty of medicine, 2022 More
  • Adel Mahmoud Attia Attia Morsi, "Enhanced recovery program after laparoscopic colorectal surgery during the era of COVID-19: a randomized controlled trial", Minerva Medical, 2022 More
  • Adel Mahmoud Attia Attia Morsi, "Endoscopic management of refractory leak and gastro‑cutaneous fistula after laparoscopic sleeve gastrectomy: a randomized controlled trial", Springer, 2022 More
  • Adel Mahmoud Attia Attia Morsi, "Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study", Baishideng Publishing Group Inc, 2023 More

Department Related Publications

  • Adel Mahmoud Attia Attia Morsi, "Endoscopic management of refractory leak and gastro‑cutaneous fistula after laparoscopic sleeve gastrectomy: a randomized controlled trial", Springer, 2022 More
  • Walid Abdamoly Sayed Ali, "Could local curative breast surgery improve survival in women with oligometastatic breast cancer?", The Egyptian Journal of Surgery, 2020,39:283–288, 2020 More
  • Hassan Rabei Jalal Abdulaziz, "Sigmoidopexy versus sigmoidectomy for sigmoid volvulus through left iliac incision in high-risk patients", Wolters Kluwer - Medknow, 2022 More
  • Yasser Ali Abdel -Razzaq Mahmoud, "Endoscopic management of low output recurrent colonic fistula or leak after anterior resection for rectal cancer: a randomized controlled trial", Springer Nature Link, 2026 More
Tweet