Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy
Background:. Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether c...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-03-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004171 |
| _version_ | 1818744542262722560 |
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| author | Romina Deldar, MD Areeg A. Abu El Hawa, BS John D. Bovill, BS Dionisio Hipolito, BS Eshetu Tefera, MS Parag Bhanot, MD Kenneth L. Fan, MD Karen K. Evans, MD |
| author_facet | Romina Deldar, MD Areeg A. Abu El Hawa, BS John D. Bovill, BS Dionisio Hipolito, BS Eshetu Tefera, MS Parag Bhanot, MD Kenneth L. Fan, MD Karen K. Evans, MD |
| author_sort | Romina Deldar, MD |
| collection | DOAJ |
| description | Background:. Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN.
Methods:. A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence.
Results:. A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, P = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm2, P = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, P = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, P = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence.
Conclusions:. Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction. |
| first_indexed | 2024-12-18T02:45:58Z |
| format | Article |
| id | doaj.art-41a76fb3f94340ceb7a45eb54c8736f6 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-18T02:45:58Z |
| publishDate | 2022-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-41a76fb3f94340ceb7a45eb54c8736f62022-12-21T21:23:33ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-03-01103e417110.1097/GOX.0000000000004171202203000-00004Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and PanniculectomyRomina Deldar, MD0Areeg A. Abu El Hawa, BS1John D. Bovill, BS2Dionisio Hipolito, BS3Eshetu Tefera, MS4Parag Bhanot, MD5Kenneth L. Fan, MD6Karen K. Evans, MD7From the * Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C.‡ Georgetown University School of Medicine, Washington, D.C.‡ Georgetown University School of Medicine, Washington, D.C.‡ Georgetown University School of Medicine, Washington, D.C.From the * Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C.† Department of General Surgery, MedStar Georgetown University Hospital, Washington, D.C.From the * Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C.From the * Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, D.C.Background:. Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN. Methods:. A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence. Results:. A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, P = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm2, P = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, P = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, P = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence. Conclusions:. Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004171 |
| spellingShingle | Romina Deldar, MD Areeg A. Abu El Hawa, BS John D. Bovill, BS Dionisio Hipolito, BS Eshetu Tefera, MS Parag Bhanot, MD Kenneth L. Fan, MD Karen K. Evans, MD Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy Plastic and Reconstructive Surgery, Global Open |
| title | Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy |
| title_full | Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy |
| title_fullStr | Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy |
| title_full_unstemmed | Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy |
| title_short | Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy |
| title_sort | negative pressure wound therapy prevents hernia recurrence in simultaneous ventral hernia repair and panniculectomy |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004171 |
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