title: Incisional negative-pressure wound therapy versus conventional dressings following abdominal wall reconstruction: a comparative study.
abstract: BACKGROUND
  Improvements in surgical techniques have allowed us to achieve primary closure in a high percentage of large abdominal hernia repairs. However, postoperative wound complications remain common. The benefits of negative-pressure wound therapy (NPWT) in the management of open abdominal wounds are well described in the literature. Our study investigates the effects of incisional NPWT after primary closure of the abdominal wall.
  
  
  METHODS
  A retrospective chart review was performed for the period between September 2008 and May 2011 to analyze the outcomes of patients treated postoperatively with incisional NPWT versus conventional dry gauze dressings. Patient information collected included history of abdominal surgeries, smoking status, and body mass index. Postoperative complications were analyzed using χ exact test and logistic regression analysis.
  
  
  RESULTS
  Fifty-six patients were included in this study; of them, 23 were treated with incisional NPWT, whereas 33 received conventional dressings. The rates of overall wound complications in groups I and II were 22% and 63.6%, respectively (P = 0.020). The rates of skin dehiscence were 9% and 39%, respectively (P = 0.014). Both outcomes achieved statistical significance. Rates of infection, skin and fat necrosis, seroma, and hernia recurrence were 4%, 9%, 0%, and 4% for group I and 6%, 18%, 12%, 9% for group II, respectively.
  
  
  CONCLUSIONS
  This study suggests that incisional NPWT following abdominal wall reconstruction significantly improves rates of wound complication and skin dehiscence when compared with conventional dressings. Prospective, randomized, controlled studies are needed to further characterize the potential benefits of this therapy on wound healing after abdominal wall reconstruction.
authors.affiliation: From the *Division of Plastic Surgery, University of Maryland Medical Center, Baltimore, MD; †Department of Surgery, University of Maryland Medical Center, Baltimore, MD; and ‡University of Maryland, School of Medicine, Baltimore, MD.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Condé-Green
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chung
authors.forename: Luther H
authors.initials: LH
authors.lastname: Holton
authors.forename: Helen G
authors.initials: HG
authors.lastname: Hui-Chou
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhu
authors.forename: Howard
authors.initials: H
authors.lastname: Wang
authors.forename: Hamid
authors.initials: H
authors.lastname: Zahiri
authors.forename: Devinder P
authors.initials: DP
authors.lastname: Singh
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation; D000328:Adult; D000368:Aged; D001458:Bandages; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome