Prophylactic surgical wound management with negative pressure therapy in emergency abdominal surgery: is it really useful?

English Title

Manejo profiláctico de herida quirúrgica con terapia por presión negativa en cirugía abdominal de emergencia: ¿realmente es útil?

Authors

Yelson Alejandro Picón Jaimes, Programa de Doctorado en Salud, Bienestar y Bioética, Universidad Ramón Llul. Barcelona, España.
Samir Alberto Caycedo Assia, Facultad de Medicina, Universidad del Sinú. Cartagena, Colombia.
Isabela Zenilma Daza Patiño, Facultad de Medicina, Universidad del Sinú. Cartagena, Colombia.
Eliecer Enrique Aragon Acosta, Facultad de Medicina, Universidad Libre. Barranquilla, Colombia
Cindy Stephanie Buitrago Almanza, Facultad de Medicina, Universidad Nacional de Colombia. Bogotá, Colombia

Abstract

Mr Editor Infection at the operating site (ISO) is the most common postoperative surgical complication in general surgery. This is more frequent in cases of emergency interventions, compromises the patient's prognosis, causes high health costs, and signicantly increases the risk of reintervention. Negative pressure therapy (NPT) is an innovative strategy that was proposed about two decades ago, and has been gradually replicated around the world. This means that there are still many gaps in the evidence when it is used in many diseases and under different contexts. Nevertheless, it allows obtaining conclusive results in the time of healing, reduction of complications (mainly dehiscence and ISO), decrease in hospital stay, among other factors. In Latin America, there is very little evidence on the use of this strategy, and it is null regarding its use in emergency cases without being able to determine its impact on our environment. Recently, Lakhani et al 3 conducted a meta-analysis of 7 studies with a total of 1199 patients, where they evaluated the ISO rate in patients undergoing emergency laparotomy in whom NPT was used (n=566) vs. control group (standard care, n=633). The NPT group had a lower infection rate (13.6% vs. 25.1%), with a 57-percentage point reduction in the probability of presenting ISO (OR 0.43; 95% CI: 0.30 - 0.62).

English Abstract

Sr. Editor, La infección en el sitio operatorio (ISO), es la complicación quirúrgica postoperatoria más frecuente en cirugía general. Esta es más frecuente en casos de intervenciones de emergencias, compromete el pronóstico del paciente, ocasiona elevados costos en salud, y aumenta considerablemente el riesgo de reintervención. La terapia por presión negativa (TPN) es una estrategia innovadora que se planteó hace aproximadamente dos décadas, y que se ha reproducido paulatinamente en todo el mundo. Esto ocasiona que aún existan diversidad de evidencia cuando es utilizada en muchísimas enfermedades y bajo diferentes contextos. No obstante, permite obtener resultados contundentes en el tiempo de cicatrización, disminución de complicaciones (principalmente dehiscencia e ISO), disminución de estancia hospitalaria, entre otros factores.

DOI

https://doi.org/10.25176/RFMH.v23i1.5291

Recommended Citation

Picón Jaimes, Yelson Alejandro; Caycedo Assia, Samir Alberto; Daza Patiño, Isabela Zenilma; Aragon Acosta, Eliecer Enrique; and Buitrago Almanza, Cindy Stephanie (2023) "Prophylactic surgical wound management with negative pressure therapy in emergency abdominal surgery: is it really useful?," Revista de la Facultad de Medicina Humana: Vol. 23: Iss. 1, Article 20.
DOI: https://doi.org/10.25176/RFMH.v23i1.5291
Available at: https://inicib.urp.edu.pe/rfmh/vol23/iss1/20