Negative Pressure Wound Therapy to Reduce Surgical Site Infections after CRS/HIPEC

Kylie J Nabata; Sabrina Rai; Darren Zhao; Andrea J MacNeill; Trevor D Hamilton

doi:10.1245/s10434-024-15283-z

Negative Pressure Wound Therapy to Reduce Surgical Site Infections after CRS/HIPEC

Ann Surg Oncol. 2024 Apr 23. doi: 10.1245/s10434-024-15283-z. Online ahead of print.

Authors

Kylie J Nabata¹, Sabrina Rai¹, Darren Zhao¹, Andrea J MacNeill¹, Trevor D Hamilton²

Affiliations

¹ Department of Surgery, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada.
² Department of Surgery, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada. trevor.hamilton@vch.ca.

PMID: 38653941
DOI: 10.1245/s10434-024-15283-z

Abstract

Background: Surgical site infections (SSIs) are a common cause of morbidity after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Negative pressure wound therapy (NPWT) has been proposed as a method to reduce the rates of SSIs; however, there is paucity in the literature on the efficacy in this population. The goal of this study was to determine whether routine use of NPWT in patients undergoing CRS/HIPEC could reduce the risk of developing SSI.

Methods: We performed a retrospective before-after study to assess the rates of SSI with NPWT compared with a standard postoperative surgical dressing (SSD) in all patients undergoing CRS/HIPEC from November 2013 to December 2021 at a single tertiary care center. The primary outcome was rate of SSI. A multivariate logistic regression analysis was performed to evaluate for risk factors for SSI.

Results: A total of 178 patients were treated with CRS/HIPEC over the study period. Seventy patients had placement of SSD, and 108 patients had placement of NPWT. Rates of SSI were 11.4% (8/70) and 5.6% (6/108) in the two groups, respectively (p = 0.16). On multivariate analysis, patients treated with NPWT had a significantly lower risk of developing an SSI (OR 0.24 [0.06, 0.92], p = 0.037). Patients living >50 km from the hospital had significantly higher risk of developing SSI (OR 2.03 [1.09, 3.78], p = 0.026).

Conclusions: These results suggest that routine use of NPWT can reduce the risk of developing an SSI in patients undergoing CRS/HIPEC for peritoneal malignancy.