Closed Incision Negative Pressure Wound Therapy is associated with reduced Surgical Site Infection after Emergency Laparotomy: A propensity matched cohort analysis

ABSTRACT NUMBER: NESTAC MEDAL FOR MEDICAL STUDENTS_3

 

AUTHOR
Omar Ali

MAIN ABSTRACT TEXT

Introduction
Surgical site infection contributes to a significant proportion of post-operative morbidity in patients undergoing emergency laparotomy. SSIs cause significant patient burden, increase length of stay and have economic implications. CINPT has been shown to reduce SSI rates in patients undergoing elective laparotomy however there is limited evidence for their use in the emergency setting. This study aims to compare rates of surgical site infection (SSI) between patients receiving closed incision negative pressure therapy (CINPT) and standard surgical dressing following emergency laparotomy through a propensity matched analysis.

Methods
A registry-based, prospective cohort study was undertaken using data from National Emergency Laparotomy Audit (NELA) database at our centre. The primary outcome measure was SSI in as defined by the Centers for Disease Control (CDC) criteria. Secondary outcomes included 30 day post-operative morbidity and grade, length of stay, 30 day mortality and readmission rates. A propensity- score matching (PSM) was performed in a 1:1 ratio to mitigate for selection bias.

Results
A total of 1484 patients were identified from the NELA dataset, PSM resulted in two equally matched cohorts with 237 patients in each arm. The rate of SSI was significantly lower in the CINPT cohort (16.9% vs 33.8%, p<0.001). There were no overall differences in 30-day morbidity, CD grade, CCI severity, length of hospital stay, re-operation rates and 30 day mortality between the two groups.

Conclusion
Prophylactic CINPT in emergency laparotomy patients is associated with a reduction in SSI rates.