Effect of Prophylactic Negative-Pressure Wound Therapy for High-Risk Wounds in Colorectal Cancer Surgery: A Randomized Controlled Trial

Abstract

Objective: To determine the effect of prophylactic negative-pressure wound therapy (pNPWT) in patients at high risk of surgical wound complications (SWCs) who underwent colorectal cancer (CRC) surgery.

Methods: In an open-label randomized controlled trial, 50 patients who underwent open CRC surgery between November 2018 and February 2020 were included. Participants were randomly assigned to the pNPWT group (n = 24) or control group (n = 26). For patients in the pNPWT group, the pNPWT device was placed on the wound for 7 days, whereas for patients in the control group, the wound was covered with a sterile gauze dressing. The primary outcome measured was 30-day SWCs: surgical site infection, hematoma, seroma, and wound dehiscence/evisceration. Secondary outcomes included postoperative wound infection assessment score and length of postoperative hospital stay.

Results: The incidence of 30-day SWCs differed significantly between the pNPWT and control groups (16.7% vs 53.8% respectively, P = .006). Patients in the pNPWT group had a significantly lower incidence of seroma than did those in the control group (8.3% vs 34.6%, P = .025). Surgical site infection occurred in 10 of 50 patients (20%) in the study: two (8.3%) in the pNPWT group and eight (30.8%) in the control group (P = .048). No hematomas or wound dehiscence/evisceration were noted in the study. There was no difference in median length of stay between groups (P = .153).

Conclusions: This study confirmed that pNPWT effectively helps prevent SWCs in high-risk wounds after open CRC surgery.

Trial registration: ClinicalTrials.gov NCT04735133.