Closed-incision negative-pressure therapy decreases complications in ventral hernia repair with concurrent panniculectomy

S. C. Diaconu, C. H.L. McNichols, L. M. Ngaage, Y. Liang, E. Ikheloa, J. Bai, Michael Grant, A. J. Nam, Y. M. Rasko

Research output: Contribution to journalArticle

Abstract

Purpose: Ventral hernia repair with concurrent panniculectomy (VHR-PAN) is associated with high wound complication rates despite reported increased patient satisfaction. Some surgeons believe negative-pressure therapy after primary closure of the surgical incision (ciNPT) may lower wound complications in high-risk abdominal wounds. This study aims to evaluate if ciNPT improves outcomes in patients undergoing VHR-PAN. Methods: An 8-year retrospective cohort study was performed on patients who underwent VHR-PAN. Patients were divided into two groups: those who received closed-incision negative-pressure therapy (“ciNPT”) and those who received standard sterile dressings (“SSD”). The primary outcome of interest was the rate of postoperative complications between these groups. Complications were subdivided into surgical site occurrences (which included surgical site occurrences that required an intervention), return to the operating room, and hernia recurrence. Results: A total of 104 patients were analyzed: 62 in the ciNPT group and 42 in the SSD group. Median follow-up duration was similar between both groups (182 days vs 195 days, p = 0.624). Patients in the ciNPT group had fewer total complications (57% vs. 83%, p = 0.004) and fewer SSO (47% vs. 69%, p = 0.025). However, no differences were noted when comparing individual complications (SSI, wound dehiscence, skin necrosis, chronic wound, seroma, and hematoma). There was no difference in return to the operating room (27% vs. 26%, p = 0.890) or hernia recurrence (21% vs 19%, p = 0.811). Multivariate analysis showed that ciNPT decreased the risk of SSOPI nearly fourfold (odds ratio 0.28, 95% CI = 0.09–0.87, p = 0.027). Conclusions: This study showed that closed-incision negative-pressure therapy in ventral hernia repair with concurrent panniculectomy may decrease the rate of wound complications in this high-risk population.

Original languageEnglish (US)
JournalHernia
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Abdominoplasty
Ventral Hernia
Herniorrhaphy
Pressure
Wounds and Injuries
Operating Rooms
Therapeutics
Bandages
Hernia
Group Psychotherapy
Seroma
Recurrence
Patient Satisfaction
Hematoma
Cohort Studies
Necrosis
Multivariate Analysis
Retrospective Studies
Odds Ratio
Skin

Keywords

  • Closed-incision negative-pressure therapy
  • Outcomes
  • Panniculectomy
  • Ventral hernia

ASJC Scopus subject areas

  • Surgery

Cite this

Diaconu, S. C., McNichols, C. H. L., Ngaage, L. M., Liang, Y., Ikheloa, E., Bai, J., ... Rasko, Y. M. (Accepted/In press). Closed-incision negative-pressure therapy decreases complications in ventral hernia repair with concurrent panniculectomy. Hernia. https://doi.org/10.1007/s10029-018-1865-2

Closed-incision negative-pressure therapy decreases complications in ventral hernia repair with concurrent panniculectomy. / Diaconu, S. C.; McNichols, C. H.L.; Ngaage, L. M.; Liang, Y.; Ikheloa, E.; Bai, J.; Grant, Michael; Nam, A. J.; Rasko, Y. M.

In: Hernia, 01.01.2018.

Research output: Contribution to journalArticle

Diaconu, S. C. ; McNichols, C. H.L. ; Ngaage, L. M. ; Liang, Y. ; Ikheloa, E. ; Bai, J. ; Grant, Michael ; Nam, A. J. ; Rasko, Y. M. / Closed-incision negative-pressure therapy decreases complications in ventral hernia repair with concurrent panniculectomy. In: Hernia. 2018.
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abstract = "Purpose: Ventral hernia repair with concurrent panniculectomy (VHR-PAN) is associated with high wound complication rates despite reported increased patient satisfaction. Some surgeons believe negative-pressure therapy after primary closure of the surgical incision (ciNPT) may lower wound complications in high-risk abdominal wounds. This study aims to evaluate if ciNPT improves outcomes in patients undergoing VHR-PAN. Methods: An 8-year retrospective cohort study was performed on patients who underwent VHR-PAN. Patients were divided into two groups: those who received closed-incision negative-pressure therapy (“ciNPT”) and those who received standard sterile dressings (“SSD”). The primary outcome of interest was the rate of postoperative complications between these groups. Complications were subdivided into surgical site occurrences (which included surgical site occurrences that required an intervention), return to the operating room, and hernia recurrence. Results: A total of 104 patients were analyzed: 62 in the ciNPT group and 42 in the SSD group. Median follow-up duration was similar between both groups (182 days vs 195 days, p = 0.624). Patients in the ciNPT group had fewer total complications (57{\%} vs. 83{\%}, p = 0.004) and fewer SSO (47{\%} vs. 69{\%}, p = 0.025). However, no differences were noted when comparing individual complications (SSI, wound dehiscence, skin necrosis, chronic wound, seroma, and hematoma). There was no difference in return to the operating room (27{\%} vs. 26{\%}, p = 0.890) or hernia recurrence (21{\%} vs 19{\%}, p = 0.811). Multivariate analysis showed that ciNPT decreased the risk of SSOPI nearly fourfold (odds ratio 0.28, 95{\%} CI = 0.09–0.87, p = 0.027). Conclusions: This study showed that closed-incision negative-pressure therapy in ventral hernia repair with concurrent panniculectomy may decrease the rate of wound complications in this high-risk population.",
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T1 - Closed-incision negative-pressure therapy decreases complications in ventral hernia repair with concurrent panniculectomy

AU - Diaconu, S. C.

AU - McNichols, C. H.L.

AU - Ngaage, L. M.

AU - Liang, Y.

AU - Ikheloa, E.

AU - Bai, J.

AU - Grant, Michael

AU - Nam, A. J.

AU - Rasko, Y. M.

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N2 - Purpose: Ventral hernia repair with concurrent panniculectomy (VHR-PAN) is associated with high wound complication rates despite reported increased patient satisfaction. Some surgeons believe negative-pressure therapy after primary closure of the surgical incision (ciNPT) may lower wound complications in high-risk abdominal wounds. This study aims to evaluate if ciNPT improves outcomes in patients undergoing VHR-PAN. Methods: An 8-year retrospective cohort study was performed on patients who underwent VHR-PAN. Patients were divided into two groups: those who received closed-incision negative-pressure therapy (“ciNPT”) and those who received standard sterile dressings (“SSD”). The primary outcome of interest was the rate of postoperative complications between these groups. Complications were subdivided into surgical site occurrences (which included surgical site occurrences that required an intervention), return to the operating room, and hernia recurrence. Results: A total of 104 patients were analyzed: 62 in the ciNPT group and 42 in the SSD group. Median follow-up duration was similar between both groups (182 days vs 195 days, p = 0.624). Patients in the ciNPT group had fewer total complications (57% vs. 83%, p = 0.004) and fewer SSO (47% vs. 69%, p = 0.025). However, no differences were noted when comparing individual complications (SSI, wound dehiscence, skin necrosis, chronic wound, seroma, and hematoma). There was no difference in return to the operating room (27% vs. 26%, p = 0.890) or hernia recurrence (21% vs 19%, p = 0.811). Multivariate analysis showed that ciNPT decreased the risk of SSOPI nearly fourfold (odds ratio 0.28, 95% CI = 0.09–0.87, p = 0.027). Conclusions: This study showed that closed-incision negative-pressure therapy in ventral hernia repair with concurrent panniculectomy may decrease the rate of wound complications in this high-risk population.

AB - Purpose: Ventral hernia repair with concurrent panniculectomy (VHR-PAN) is associated with high wound complication rates despite reported increased patient satisfaction. Some surgeons believe negative-pressure therapy after primary closure of the surgical incision (ciNPT) may lower wound complications in high-risk abdominal wounds. This study aims to evaluate if ciNPT improves outcomes in patients undergoing VHR-PAN. Methods: An 8-year retrospective cohort study was performed on patients who underwent VHR-PAN. Patients were divided into two groups: those who received closed-incision negative-pressure therapy (“ciNPT”) and those who received standard sterile dressings (“SSD”). The primary outcome of interest was the rate of postoperative complications between these groups. Complications were subdivided into surgical site occurrences (which included surgical site occurrences that required an intervention), return to the operating room, and hernia recurrence. Results: A total of 104 patients were analyzed: 62 in the ciNPT group and 42 in the SSD group. Median follow-up duration was similar between both groups (182 days vs 195 days, p = 0.624). Patients in the ciNPT group had fewer total complications (57% vs. 83%, p = 0.004) and fewer SSO (47% vs. 69%, p = 0.025). However, no differences were noted when comparing individual complications (SSI, wound dehiscence, skin necrosis, chronic wound, seroma, and hematoma). There was no difference in return to the operating room (27% vs. 26%, p = 0.890) or hernia recurrence (21% vs 19%, p = 0.811). Multivariate analysis showed that ciNPT decreased the risk of SSOPI nearly fourfold (odds ratio 0.28, 95% CI = 0.09–0.87, p = 0.027). Conclusions: This study showed that closed-incision negative-pressure therapy in ventral hernia repair with concurrent panniculectomy may decrease the rate of wound complications in this high-risk population.

KW - Closed-incision negative-pressure therapy

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