New advances in negative pressure wound therapy (NPWT) for surgical wounds of patients affected with Crohn's disease.
Surgical site complications (SSC) negatively affect costs of care and prolong length of stay. Crohn's disease (CD) is a risk factor for SSC. CD patients often need surgery, sometimes requiring stoma. Our primary aim was to compare the effects on SSC of a portable device for NPWT (PICO, Smith & Nephew, London, UK) with gauze dressings after elective surgery for CD. Secondary aims were manageability and safety of PICO and its feasibility as home therapy. Between 2010 and 2012, 50 patients were assigned to treatment with either PICO (n = 25) or conventional dressings (n = 25). Each patient completed 12-month follow-up. Parameters of interests for primary aim were SSC, surgical complications, and readmission rates. Data on difficulties in managing PICO and device-related complications were also collected. Patients receiving PICO had less SSC, resulting in shorter hospital stay. At last follow-up, readmission rates were lower with PICO. No differences were observed in surgical complications between groups. No patients reported difficulties in managing the device. Among patients discharged with PICO, none needed to come back to the hospital for device malfunctioning or inability to manage it. PICO reduces SSC and length of stay in selected CD patients compared with conventional dressings. The device is safe and user friendly.
Unit of General Surgery Second University of Naples Naples, Italy.
Francesco
F
Selvaggi
Unit of General Surgery Second University of Naples Naples, Italy.
Gianluca
G
Pellino
Unit of General Surgery Second University of Naples Naples, Italy.
Guido
G
Sciaudone
Unit of General Surgery Second University of Naples Naples, Italy.
Angela Della
AD
Corte
Unit of General Surgery Second University of Naples Naples, Italy.
Giuseppe
G
Candilio
Unit of General Surgery Second University of Naples Naples, Italy.
Ferdinando
F
Campitiello
Unit of General Surgery Second University of Naples Naples, Italy.
Silvestro
S
Canonico
D000293:Adolescent; D000328:Adult; D001458:Bandages; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D055815:Young Adult