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      Meta‐analysis of negative‐pressure wound therapy for closed surgical incisions

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          Abstract

          Background

          Postoperative wound complications are common following surgical procedures. Negative‐pressure wound therapy ( NPWT) is well recognized for the management of open wounds and has been applied recently to closed surgical incisions. The evidence base to support this intervention is limited. The aim of this study was to assess whether NPWT reduces postoperative wound complications when applied to closed surgical incisions.

          Methods

          This was a systematic review and meta‐analysis of randomized clinical trials of NPWT compared with standard postoperative dressings on closed surgical incisions.

          Results

          Ten studies met the inclusion criteria, reporting on 1311 incisions in 1089 patients. NPWT was associated with a significant reduction in wound infection (relative risk ( RR) 0·54, 95 per cent c.i. 0·33 to 0·89) and seroma formation ( RR 0·48, 0·27 to 0·84) compared with standard care. The reduction in wound dehiscence was not significant. The numbers needed to treat were three (seroma), 17 (dehiscence) and 25 (infection). Methodological heterogeneity across studies led to downgrading of the quality of evidence to moderate for infection and seroma, and low for dehiscence.

          Conclusion

          Compared with standard postoperative dressings, NPWT significantly reduced the rate of wound infection and seroma when applied to closed surgical wounds. Heterogeneity between the included studies means that no general recommendations can be made yet.

          Abstract

          Good for closed wounds too

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          Most cited references 27

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          Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.

          Despite numerous advances, chronic and other difficult-to-manage wounds continue to be a treatment challenge. Presented is a new subatmospheric pressure technique: vacuum-assisted closure (The V.A.C.). The V.A.C. technique entails placing an open-cell foam dressing into the wound cavity and applying a controlled subatmospheric pressure (125 mmHg below ambient pressure). Three hundred wounds were treated: 175 chronic wounds, 94 subacute wounds, and 31 acute wounds. Two hundred ninety-six wounds responded favorably to subatmospheric pressure treatment, with an increased rate of granulation tissue formation. Wounds were treated until completely closed, were covered with a split-thickness skin graft, or a flap was rotated into the health, granulating would bed. The technique removes chronic edema, leading to increased localized blood flow, and the applied forces result in the enhanced formation of granulation tissue. Vacuum-assisted closure is an extremely efficacious modality for treating chronic and difficult wounds.
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            Vacuum-Assisted Closure: A New Method for Wound Control and Treatment

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              • Article: not found

              Surgical wound infection rates by wound class, operative procedure, and patient risk index

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                Author and article information

                Journal
                Br J Surg
                Br J Surg
                10.1002/(ISSN)1365-2168
                BJS
                The British Journal of Surgery
                John Wiley & Sons, Ltd (Chichester, UK )
                0007-1323
                1365-2168
                16 March 2016
                April 2016
                : 103
                : 5 ( doiID: 10.1002/bjs.2016.103.issue-5 )
                : 477-486
                Affiliations
                [ 1 ] Department of Plastic SurgeryOdense University Hospital, University of Southern Denmark, Institute of Clinical Research, Research Unit of Plastic Surgery OdenseDenmark
                [ 2 ] Department of Gynaecology and ObstetricsOdense University Hospital, University of Southern Denmark, Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics OdenseDenmark
                [ 3 ] Centre for Health Economics Research (COHERE)University of Southern Denmark OdenseDenmark
                [ 4 ] Institute of Clinical MedicineAarhus University Hospital AarhusDenmark
                [ 5 ] Division of SurgeryUniversity College London, Northwick Park Institute of Medical Research Campus LondonUK
                Author notes
                [* ] Correspondence to: Ms N. Hyldig, Kloevervaenget 10, 10th Floor, Odense University Hospital, 5000 Odense, Denmark (e‐mail: nana.hyldig@ 123456rsyd.dk )
                Article
                BJS10084 BJS-0999-Jul-15.R1
                10.1002/bjs.10084
                5069647
                26994715
                © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                Page count
                Pages: 10
                Product
                Categories
                Systematic Review
                Systematic Reviews
                Custom metadata
                2.0
                bjs10084
                April 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.5 mode:remove_FC converted:19.10.2016

                Surgery

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