Novel wound management system reduction of surgical site morbidity after ventral hernia repairs: A critical analysis

Kevin C. Soares, Pablo A. Baltodano, Caitlin W. Hicks, Carisa M. Cooney, Israel O. Olorundare, Peter Cornell, Karen Burce, Frederic E. Eckhauser

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)324-332
Number of pages9
JournalAmerican journal of surgery
Volume209
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • Incisional hernia
  • Keywords Ventral hernia
  • Negative-pressure wound therapy
  • Surgical site infection
  • Surgical site occurrence
  • Vacuum-assisted closure

ASJC Scopus subject areas

  • Surgery

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