PROPHYLACTIC NPWT AT ILEOSTOMY CLOSURE IN PATIENTS AFTER COLORECTAL CANCER OPERATION REDUCE COMPLETE WOUND HEALING TIME - PROSPECTIVE CLINICAL TRIAL
EAES Academy. Wierdak M. 07/05/22; 363024; P068
Dr. Mateusz Wierdak
Contributions
Contributions
Abstract
Aims:
We performed a prospective control trial to assess the usefulness of postoperative NPWT in the reduction of postoperative wound healing complications ,complete wound healing time and surgical site infections after diverting ileostomy closure, in the group of patients previously operated for colorectal resection due to cancer.
Methods:
Prospective study between January 2016 and December 2021 was conducted. Patients with a past history of laparoscopic colorectal surgery due to cancer with protective loop ileostomy scheduled to undergo ileostomy closure with primary wound closure were randomly divided into groups with or without NPWT. Pourse string technique was used in control group. The primary endpoint was the incidence of wound-related complications (WRC) (wound healing complications witch required surgical intervention other than suture removal or dressing changing), and and length of complete wound healing (CWH). The secondary endpoints were incidences of Surgical Site Infection (SSI),the length of postoperative hospital stay (LOS) and assessment of the cosmetic effect of the postoperative scar (by visual analog scale (VAS) and patients satisfaction questionare) 1 and 6 months after surgery.
Results:
A total of 35 patients with primary wound closure with Purse String Technique (PST)) and 40 patients with primary wound closure by single skin sutures + NPWT (NPWT group) were enrolled.There were no diferences in WRC ( 6 patients in the PST group, and 4 patient in the NPWT group (p = 0.43) and SSI incidence (4 in SPT group and 3 in SSS + NPWT group) (p =0.83). Median CWH was significantly shorter in NPWT group [21 (14-28) days in PST group; 7 (7-7)days in NPWT group; p=0.0302]. There was no difference in LOS between the two groups [median LOS : PST group - 4 (2,5-5) days; NPWT group 4 (2-4) days; p= 0,39].We observed siggnificantly better cosmetic short term ( 1 month) outcome in NPWT group in VAS scale [ 6,3 (5,3-7,3) days in PST group; 8,4 (7,9-9,0)days in NPWT group; p=0.043] without difference in long term (6 months) cosmetic outcome.
Conclusion:
Prophylactic postoperative NPWT compared to PST after diverting ileostomy closure in colorectal cancer patients reduces CWH and gives better cosmetic outcome in short term observation, without differences in WMC, SSI incidance and LOS.
We performed a prospective control trial to assess the usefulness of postoperative NPWT in the reduction of postoperative wound healing complications ,complete wound healing time and surgical site infections after diverting ileostomy closure, in the group of patients previously operated for colorectal resection due to cancer.
Methods:
Prospective study between January 2016 and December 2021 was conducted. Patients with a past history of laparoscopic colorectal surgery due to cancer with protective loop ileostomy scheduled to undergo ileostomy closure with primary wound closure were randomly divided into groups with or without NPWT. Pourse string technique was used in control group. The primary endpoint was the incidence of wound-related complications (WRC) (wound healing complications witch required surgical intervention other than suture removal or dressing changing), and and length of complete wound healing (CWH). The secondary endpoints were incidences of Surgical Site Infection (SSI),the length of postoperative hospital stay (LOS) and assessment of the cosmetic effect of the postoperative scar (by visual analog scale (VAS) and patients satisfaction questionare) 1 and 6 months after surgery.
Results:
A total of 35 patients with primary wound closure with Purse String Technique (PST)) and 40 patients with primary wound closure by single skin sutures + NPWT (NPWT group) were enrolled.There were no diferences in WRC ( 6 patients in the PST group, and 4 patient in the NPWT group (p = 0.43) and SSI incidence (4 in SPT group and 3 in SSS + NPWT group) (p =0.83). Median CWH was significantly shorter in NPWT group [21 (14-28) days in PST group; 7 (7-7)days in NPWT group; p=0.0302]. There was no difference in LOS between the two groups [median LOS : PST group - 4 (2,5-5) days; NPWT group 4 (2-4) days; p= 0,39].We observed siggnificantly better cosmetic short term ( 1 month) outcome in NPWT group in VAS scale [ 6,3 (5,3-7,3) days in PST group; 8,4 (7,9-9,0)days in NPWT group; p=0.043] without difference in long term (6 months) cosmetic outcome.
Conclusion:
Prophylactic postoperative NPWT compared to PST after diverting ileostomy closure in colorectal cancer patients reduces CWH and gives better cosmetic outcome in short term observation, without differences in WMC, SSI incidance and LOS.
Aims:
We performed a prospective control trial to assess the usefulness of postoperative NPWT in the reduction of postoperative wound healing complications ,complete wound healing time and surgical site infections after diverting ileostomy closure, in the group of patients previously operated for colorectal resection due to cancer.
Methods:
Prospective study between January 2016 and December 2021 was conducted. Patients with a past history of laparoscopic colorectal surgery due to cancer with protective loop ileostomy scheduled to undergo ileostomy closure with primary wound closure were randomly divided into groups with or without NPWT. Pourse string technique was used in control group. The primary endpoint was the incidence of wound-related complications (WRC) (wound healing complications witch required surgical intervention other than suture removal or dressing changing), and and length of complete wound healing (CWH). The secondary endpoints were incidences of Surgical Site Infection (SSI),the length of postoperative hospital stay (LOS) and assessment of the cosmetic effect of the postoperative scar (by visual analog scale (VAS) and patients satisfaction questionare) 1 and 6 months after surgery.
Results:
A total of 35 patients with primary wound closure with Purse String Technique (PST)) and 40 patients with primary wound closure by single skin sutures + NPWT (NPWT group) were enrolled.There were no diferences in WRC ( 6 patients in the PST group, and 4 patient in the NPWT group (p = 0.43) and SSI incidence (4 in SPT group and 3 in SSS + NPWT group) (p =0.83). Median CWH was significantly shorter in NPWT group [21 (14-28) days in PST group; 7 (7-7)days in NPWT group; p=0.0302]. There was no difference in LOS between the two groups [median LOS : PST group - 4 (2,5-5) days; NPWT group 4 (2-4) days; p= 0,39].We observed siggnificantly better cosmetic short term ( 1 month) outcome in NPWT group in VAS scale [ 6,3 (5,3-7,3) days in PST group; 8,4 (7,9-9,0)days in NPWT group; p=0.043] without difference in long term (6 months) cosmetic outcome.
Conclusion:
Prophylactic postoperative NPWT compared to PST after diverting ileostomy closure in colorectal cancer patients reduces CWH and gives better cosmetic outcome in short term observation, without differences in WMC, SSI incidance and LOS.
We performed a prospective control trial to assess the usefulness of postoperative NPWT in the reduction of postoperative wound healing complications ,complete wound healing time and surgical site infections after diverting ileostomy closure, in the group of patients previously operated for colorectal resection due to cancer.
Methods:
Prospective study between January 2016 and December 2021 was conducted. Patients with a past history of laparoscopic colorectal surgery due to cancer with protective loop ileostomy scheduled to undergo ileostomy closure with primary wound closure were randomly divided into groups with or without NPWT. Pourse string technique was used in control group. The primary endpoint was the incidence of wound-related complications (WRC) (wound healing complications witch required surgical intervention other than suture removal or dressing changing), and and length of complete wound healing (CWH). The secondary endpoints were incidences of Surgical Site Infection (SSI),the length of postoperative hospital stay (LOS) and assessment of the cosmetic effect of the postoperative scar (by visual analog scale (VAS) and patients satisfaction questionare) 1 and 6 months after surgery.
Results:
A total of 35 patients with primary wound closure with Purse String Technique (PST)) and 40 patients with primary wound closure by single skin sutures + NPWT (NPWT group) were enrolled.There were no diferences in WRC ( 6 patients in the PST group, and 4 patient in the NPWT group (p = 0.43) and SSI incidence (4 in SPT group and 3 in SSS + NPWT group) (p =0.83). Median CWH was significantly shorter in NPWT group [21 (14-28) days in PST group; 7 (7-7)days in NPWT group; p=0.0302]. There was no difference in LOS between the two groups [median LOS : PST group - 4 (2,5-5) days; NPWT group 4 (2-4) days; p= 0,39].We observed siggnificantly better cosmetic short term ( 1 month) outcome in NPWT group in VAS scale [ 6,3 (5,3-7,3) days in PST group; 8,4 (7,9-9,0)days in NPWT group; p=0.043] without difference in long term (6 months) cosmetic outcome.
Conclusion:
Prophylactic postoperative NPWT compared to PST after diverting ileostomy closure in colorectal cancer patients reduces CWH and gives better cosmetic outcome in short term observation, without differences in WMC, SSI incidance and LOS.
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