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Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial
BACKGROUND: The American Society of Surgery and American Society for Surgical Infections issued guidelines for surgical site infections (SSIs) in December 2016. These guidelines recommend a purse-string suture (PSS) for stoma closure as it facilitates granulation and enables open wound drainage. Thi...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713411/ https://www.ncbi.nlm.nih.gov/pubmed/34963451 http://dx.doi.org/10.1186/s12893-021-01446-2 |
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author | Kojima, Koichiro Goto, Mayu Nagashima, Yasuo Saito, Yoko Kawai, Masaya Takebe, Shihori Egawa, Akiko Tanba, Mitsuko Ishikawa, Kazue Matsuoka, Hiroyoshi Masaki, Tadahiko Sunami, Eiji Ohura, Norihiko Teruya, Koji Eto, Ken Nozawa, Keijiro Sakamoto, Kazuhiro Funahashi, Kimihiko |
author_facet | Kojima, Koichiro Goto, Mayu Nagashima, Yasuo Saito, Yoko Kawai, Masaya Takebe, Shihori Egawa, Akiko Tanba, Mitsuko Ishikawa, Kazue Matsuoka, Hiroyoshi Masaki, Tadahiko Sunami, Eiji Ohura, Norihiko Teruya, Koji Eto, Ken Nozawa, Keijiro Sakamoto, Kazuhiro Funahashi, Kimihiko |
author_sort | Kojima, Koichiro |
collection | PubMed |
description | BACKGROUND: The American Society of Surgery and American Society for Surgical Infections issued guidelines for surgical site infections (SSIs) in December 2016. These guidelines recommend a purse-string suture (PSS) for stoma closure as it facilitates granulation and enables open wound drainage. This study investigated the effect of using negative pressure wound therapy (NPWT) along with standard PSS and aimed to determine the optimal period of NPWT use. METHODS: The patients were divided into three groups as follows: Group A, postoperative wound management alone with gauze exchange as the representative of conventional PSS; Group B, the performed management was similar to that of Group A plus NPWT for 1 week; and Group C, the performed management was similar to that of Group A plus NPWT for 2 weeks. Regarding objective measures, the wound reduction rate was the primary outcome, and the incidence of SSIs, length of hospital stay, and wound healing duration were the secondary outcomes. RESULTS: In total, 30 patients (male: 18, female: 12) were enrolled. The average age was 63 (range: 43–84) years. The wound reduction rate was significantly higher in Group B than in Group A on postoperative days (PODs) 7 (66.1 vs. 48.4%, p = 0.049) and 10 (78.6 vs. 58.2%, p = 0.011), whereas no significant difference was observed on POD 14. Compared with Group A, Group C (POD 7: 65.9%, POD 10: 69.2%) showed an increase in the wound reduction rate on POD 7, although the difference was not significant (p = 0.075). SSIs were observed in Groups B (n = 2) and C (n = 2) (20%) but not in Group A (0%). CONCLUSIONS: The most effective duration of NPWT use for ileostomy closure with PSS in terms of the maximum wound reduction rate was from PODs 3 to 10. However, NPWT did not shorten the wound healing duration. NPWT may reduce the wound size but should be used with precautions for SSIs. The small sample size (30 cases), the use of only one type of NPWT system, and the fact that wound assessment was subjective and not blinded were the limitations of this study. Further studies are needed to confirm our findings. Trial registration: UMIN Clinical Trials Registry; UMIN000032174 (10/04/2018). |
format | Online Article Text |
id | pubmed-8713411 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87134112022-01-05 Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial Kojima, Koichiro Goto, Mayu Nagashima, Yasuo Saito, Yoko Kawai, Masaya Takebe, Shihori Egawa, Akiko Tanba, Mitsuko Ishikawa, Kazue Matsuoka, Hiroyoshi Masaki, Tadahiko Sunami, Eiji Ohura, Norihiko Teruya, Koji Eto, Ken Nozawa, Keijiro Sakamoto, Kazuhiro Funahashi, Kimihiko BMC Surg Research BACKGROUND: The American Society of Surgery and American Society for Surgical Infections issued guidelines for surgical site infections (SSIs) in December 2016. These guidelines recommend a purse-string suture (PSS) for stoma closure as it facilitates granulation and enables open wound drainage. This study investigated the effect of using negative pressure wound therapy (NPWT) along with standard PSS and aimed to determine the optimal period of NPWT use. METHODS: The patients were divided into three groups as follows: Group A, postoperative wound management alone with gauze exchange as the representative of conventional PSS; Group B, the performed management was similar to that of Group A plus NPWT for 1 week; and Group C, the performed management was similar to that of Group A plus NPWT for 2 weeks. Regarding objective measures, the wound reduction rate was the primary outcome, and the incidence of SSIs, length of hospital stay, and wound healing duration were the secondary outcomes. RESULTS: In total, 30 patients (male: 18, female: 12) were enrolled. The average age was 63 (range: 43–84) years. The wound reduction rate was significantly higher in Group B than in Group A on postoperative days (PODs) 7 (66.1 vs. 48.4%, p = 0.049) and 10 (78.6 vs. 58.2%, p = 0.011), whereas no significant difference was observed on POD 14. Compared with Group A, Group C (POD 7: 65.9%, POD 10: 69.2%) showed an increase in the wound reduction rate on POD 7, although the difference was not significant (p = 0.075). SSIs were observed in Groups B (n = 2) and C (n = 2) (20%) but not in Group A (0%). CONCLUSIONS: The most effective duration of NPWT use for ileostomy closure with PSS in terms of the maximum wound reduction rate was from PODs 3 to 10. However, NPWT did not shorten the wound healing duration. NPWT may reduce the wound size but should be used with precautions for SSIs. The small sample size (30 cases), the use of only one type of NPWT system, and the fact that wound assessment was subjective and not blinded were the limitations of this study. Further studies are needed to confirm our findings. Trial registration: UMIN Clinical Trials Registry; UMIN000032174 (10/04/2018). BioMed Central 2021-12-28 /pmc/articles/PMC8713411/ /pubmed/34963451 http://dx.doi.org/10.1186/s12893-021-01446-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kojima, Koichiro Goto, Mayu Nagashima, Yasuo Saito, Yoko Kawai, Masaya Takebe, Shihori Egawa, Akiko Tanba, Mitsuko Ishikawa, Kazue Matsuoka, Hiroyoshi Masaki, Tadahiko Sunami, Eiji Ohura, Norihiko Teruya, Koji Eto, Ken Nozawa, Keijiro Sakamoto, Kazuhiro Funahashi, Kimihiko Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title | Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title_full | Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title_fullStr | Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title_full_unstemmed | Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title_short | Effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase II randomized controlled trial |
title_sort | effectiveness of negative pressure wound therapy for the wound of ileostomy closure: a multicenter, phase ii randomized controlled trial |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713411/ https://www.ncbi.nlm.nih.gov/pubmed/34963451 http://dx.doi.org/10.1186/s12893-021-01446-2 |
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