title: A simple vacuum dressing reduces the wound infection rate of single-incision pediatric endosurgical appendectomy.
abstract: OBJECTIVE
  After introducing single-incision pediatric endosurgical (SIPES) appendectomy at our institution, we noticed an increased number of post-operative umbilical infections. This study evaluates the impact of a simple, low-cost wound vacuum dressing on the wound infection rate.
  
  
  METHODS
  Umbilical wounds after single-incision laparoscopic appendectomy were covered with standard dressing (approximating strips), or the new umbilical vacuum dressing. A wound infection was defined as an infected umbilicus requiring antibiotics, or incision and drainage. The wound infection rate was compared between both groups. Statistical analysis was performed using Fischer's exact test. Continuous variables were compared using the Student t test.
  
  
  RESULTS
  Included in this study were 183 children, 97 of whom were treated with the vacuum dressing. The study populations were no different in terms of age, weight, operative time, blood loss, length of stay, or proportion of acute versus perforated appendicitis. A total of 7 (3.8%) wound infections occurred, 1 in the vacuum dressing group (1%), versus 6 in the conventional dressing group (7%, P=0.038).
  
  
  CONCLUSIONS
  This simple, low-cost umbilical vacuum dressing decreased the wound infection rate after SIPES appendectomy, possibly by absorbing secretions from the base of the wound. It may be equally effective for other indications.
authors: Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA. oliver.muensterer@att.net
authors: Oliver J
authors: OJ
authors: Muensterer
authors: Richard
authors: R
authors: Keijzer
mesh_terms: D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods*; D001458:Bandages; D005260:Female; D006801:Humans; D008297:Male; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014472:Umbilicus; D014618:Vacuum