# Evaluation of Negative Pressure Dressings for Closed Surgical Incisions in Decreasing Surgical Site Infections After Emergency Laparotomy: A Randomized Controlled Study

## TL;DR

This study found that negative pressure dressings reduced surgical site infections after emergency abdominal surgery but did not affect hospital stay or scar appearance.

## Contribution

This is the first randomized controlled trial demonstrating that negative pressure dressings significantly decrease surgical site infections after emergency laparotomy.

## Key findings

- Negative pressure dressings reduced surgical site infections from 70% to 30% compared to conventional dressings.
- There was no significant difference in hospital stay duration between the two groups.
- Cosmetic outcomes, as measured by the Vancouver Scar Scale, were not significantly different between groups.

## Abstract

Objectives

The aim of this study is to compare the effectiveness of negative pressure dressings (NPDs) versus conventional dressings for closed surgical incisions after emergency midline laparotomy, focusing on their impact on surgical site infection (SSI) rates, wound dehiscence, hospital stay duration, and cosmetic outcomes.

Methods

The randomized controlled study was conducted over 24 months, involving 80 patients aged 18-65 years who had peritonitis and underwent emergency midline laparotomies. Patients with diabetes mellitus, a BMI >35 kg/m², immunocompromised conditions, or those requiring re-exploration within 30 days of surgery were excluded. The participants were randomly assigned into two groups using a computer-generated randomization table: Group A, the case group, consisted of 40 patients who received NPDs, while Group B, the control group, included 40 patients who received conventional dressings. Data were recorded in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA), with a p-value of <0.05 considered statistically significant.

Results

The overall occurrence of SSIs within the 30-day follow-up period was significantly lower in the NPD group compared to the conventional dressing group (30% vs. 70%, p < 0.05). The mean duration of hospital stay was 14.85 ± 10.43 days for the NPD group and 15.4 ± 9.75 days for the control group, with no statistically significant difference (p = 0.712). The mean Vancouver Scar Scale score was 5.3 ± 2.47 in the NPD group and 6.5 ± 2.14 in the control group, also showing no statistically significant difference (p = 0.11).

Conclusions

NPDs significantly reduced the incidence of SSIs compared to conventional dressings, but they did not have a significant impact on scar cosmesis or the duration of hospital stay.