Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure  

作　　者：Deng-Yong Xu Bing-Jun Bai Lina Shan Hui-Yan Wei Deng-Feng Lin Ya Wang Da Wang 

机构地区：[1]Department of Colorectal Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang Province,China [2]Department of Wound&Ostomy Care Clinic,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang Province,China [3]Department of Hospital Infection Control,Zhejiang Cancer Hospital,Hangzhou 310005,Zhejiang Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第1期186-195,共10页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by the Zhejiang Provincial Natural Science Foundation of China,No.LQ20H260002.

摘　　要：BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.

关 键 词：Micro-power negative pressure technique Ileostomy closure Incisional surgical site infection Infection prevention Postoperative incision 

分 类 号：R656[医药卫生—外科学]