TY - JOUR
T1 - Novel wound management system reduction of surgical site morbidity after ventral hernia repairs
T2 - A critical analysis
AU - Soares, Kevin C.
AU - Baltodano, Pablo A.
AU - Hicks, Caitlin W.
AU - Cooney, Carisa M.
AU - Olorundare, Israel O.
AU - Cornell, Peter
AU - Burce, Karen
AU - Eckhauser, Frederic E.
N1 - Funding Information:
This study was made possible in part through an investigator-initiated trial grant from KCI grant number 115258 .
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR. Methods A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings. Multivariable logistic regression compared surgical site infections, surgical site occurrences, morbidity, and reoperation rates. Results We evaluated 199 patients (115 HVAC vs 84 standard wound dressing patients). Mean follow-up was 9 months. The HVAC cohort had lower surgical site infections (9% vs 32%, P <.001) and surgical site occurrences (17% vs 42%, P =.001) rates. Rates of major morbidity (19% vs 31%, P =.04) and 90-day reoperation (5% vs 14%, P =.02) were lower in the HVAC cohort. Conclusions The HVAC system is associated with optimized outcomes following open VHR. Prospective studies should validate these findings and define the economic implications of this intervention.
AB - Background Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR. Methods A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings. Multivariable logistic regression compared surgical site infections, surgical site occurrences, morbidity, and reoperation rates. Results We evaluated 199 patients (115 HVAC vs 84 standard wound dressing patients). Mean follow-up was 9 months. The HVAC cohort had lower surgical site infections (9% vs 32%, P <.001) and surgical site occurrences (17% vs 42%, P =.001) rates. Rates of major morbidity (19% vs 31%, P =.04) and 90-day reoperation (5% vs 14%, P =.02) were lower in the HVAC cohort. Conclusions The HVAC system is associated with optimized outcomes following open VHR. Prospective studies should validate these findings and define the economic implications of this intervention.
KW - Incisional hernia
KW - Keywords Ventral hernia
KW - Negative-pressure wound therapy
KW - Surgical site infection
KW - Surgical site occurrence
KW - Vacuum-assisted closure
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U2 - 10.1016/j.amjsurg.2014.06.022
DO - 10.1016/j.amjsurg.2014.06.022
M3 - Article
C2 - 25194761
AN - SCOPUS:84922654198
SN - 0002-9610
VL - 209
SP - 324
EP - 332
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -