title: Negative-Pressure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal: An Initial Study.
abstract: OBJECTIVE
  To evaluate if the application of a negative-pressure therapy system (Prevena Incision Management System, Kinetics Concepts Inc, [KCI] an Acelity Company, San Antonio, Texas) on ileostomy-closure surgical wounds would reduce surgical site infections (SSIs) in comparison with conventional closure and dressing.
  
  
  METHODS
  Prospective interventional pilot study.
  
  
  METHODS
  La Paz University Hospital, tertiary care academic hospital in Madrid, Spain.
  
  
  METHODS
  The Prevena device was applied on the wounds of 17 consecutive patients undergoing ileostomy reversal. Control subjects were 43 patients undergoing the same procedure, in which conventional dressings were used for the wound.
  
  
  METHODS
  The device was applied on the wound immediately after surgery (under sterile conditions) and maintained for 5 to 7 days. Patients were evaluated daily, and on the seventh postoperative day, the device was removed and wounds carefully inspected. Another evaluation was performed a month after the surgical intervention in the outpatient clinic.
  
  
  METHODS
  The primary end point of the study was the detection of SSI (defined according to the Centers for Disease Control and Prevention definitions). Other intervention-related complications were also registered.
  
  
  RESULTS
  There were no significant differences in demographic variables between groups. In the control group, 9 patients (21%) presented SSI, with statistical significance (P < .038) when compared with the intervention group (0%). There were no complications associated with the application of the Prevena device. Other complications (for example, ileus or obstruction) occurred in 30% of patients.
  
  
  CONCLUSIONS
  The negative-pressure Prevena System was safe and easy to use and may prevent SSIs in dirty wounds, such as those from ileostomy closure.
authors: Ramon Cantero, MD, PhD, is a Surgeon; Ines Rubio-Perez, MD, PhD, is a Surgeon; Miguel Leon, MD, is a Surgeon; Mario Alvarez, MD, is a Surgeon; Beatriz Diaz, MD, is a Surgeon; Ana Herrera, MD, is a Surgeon; Joaquin Diaz-Dominguez, MD, PhD, is a Surgeon; and Jose Antonio Rodriguez-Montes, MD, PhD, is a Surgeon and Professor of Surgery; all in the General and Digestive Surgery Department, La Paz University Hospital, Madrid, Spain.
authors: Ramon
authors: R
authors: Cantero
authors: Ines
authors: I
authors: Rubio-Perez
authors: Miguel
authors: M
authors: Leon
authors: Mario
authors: M
authors: Alvarez
authors: Beatriz
authors: B
authors: Diaz
authors: Ana
authors: A
authors: Herrera
authors: Joaquin
authors: J
authors: Diaz-Dominguez
authors: Jose Antonio
authors: JA
authors: Rodriguez-Montes
mesh_terms: D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D007415:Intestinal Obstruction / Q000601:surgery; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D012307:Risk Factors; D013030:Spain; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome