Local Negative-pressure Wound Therapy for Open Wounds after Surgery to Treat Lower Gastrointestinal Perforation

Abstract

Patients with acute diffuse peritonitis due to lower gastrointestinal perforation have an extremely high rate of postoperative surgical site infection (SSI), and if this occurs, the wound takes a long time to heal. In our hospital, rather than closing such wounds immediately with skin sutures, since 2014 we have been providing local negative-pressure wound therapy (NPWT) for open wounds and carrying out delayed primary closure at a later date as a measure to prevent SSIs. Of the 53 patients who underwent emergency surgery for acute diffuse peritonitis due to lower gastrointestinal perforation in our hospital between February 2014 and December 2018, 27 underwent postoperative NPWT (Group A), and 26 underwent primary skin suturing as part of the original surgery (Group B). Single-stage double-layer suturing was performed for patients in Group B. There were 4 SSI cases (14.8%) in Group A and 9 (34.6%) in Group B. The mean time to delayed primary suturing in Group A was 9.0 days. Our experience with the use of NPWT suggests that it may be useful for preventing wound SSIs.