title: Applying vacuum to accomplish reduced wound infections in laparoscopic pediatric surgery.
abstract: BACKGROUND
  The prevention of surgical site infections has received little attention in pediatric surgery. Negative pressure wound therapy is used to treat complex wounds. We hypothesized that this principle could reduce wound infection rates following laparoscopic surgery. We tested this in a randomized controlled trial.
  
  
  METHODS
  We randomized pediatric patients with an umbilical port site to a standard dressing or a vacuum dressing. The dressings were removed 48h after surgery. A nurse blinded for the treatment inspected the umbilical wound between post-operative days 7-10 for infection. Data comparison was performed using a Fisher exact test with p<0.05 defined as significant.
  
  
  RESULTS
  We recruited 90 patients over 2 years and randomized 44 to the vacuum dressing arm and 42 to the control arm. We observed a 2.8% (n=1/35) infection rate in the vacuum dressing group and 3.3% (n=1/30) in the control group (p=1.0).
  
  
  CONCLUSIONS
  We ended our study early when an interim analysis showed an impractical number of patients would be required to achieve sufficient power. We did not find a significant difference between the control and vacuum dressings in reducing post-operative wound infections.
  
  
  METHODS
  3.
authors.affiliation: Department of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Visser
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Kris
authors.initials: K
authors.lastname: Milbrandt
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Suyin
authors.initials: S
authors.lastname: Lum Min
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Nathan
authors.initials: N
authors.lastname: Wiseman
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Betty-Jean
authors.initials: BJ
authors.lastname: Hancock
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Morris
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics & Child Health and Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: richardkeijzer@gmail.com.
authors.forename: Richard
authors.initials: R
authors.lastname: Keijzer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D054843:Negative-Pressure Wound Therapy; D010372:Pediatrics; D011182:Postoperative Care / Q000379:methods*; D016037:Single-Blind Method; D013043:Specialties, Surgical; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Pediatric laparoscopic surgery; Surgical site infection; Vacuum dressing