None listed
Conditions
Brief summary
Background: Surgical site infection is a major reason for readmission to hospital. The evidence for prophylactic negative pressure wound therapy (suction wound dressing), for reducing wound complications, is conflicting. However, it seems likely that a benefit may be seen in appropriately selected, high risk patients. Aim: To evaluate if surgical site infections requiring readmission, are reduced following introduction of prophylactic negative pressure wound therapy for high risk patients. Methods: Medical records will be reviewed retrospectively prior to, and following, implementation of a clinical guideline promoting selective use of the Smith & Nephew PICO negative pressure wound therapy system. Population: All women undergoing open abdominal surgery where the responsible clinician is an obstetrician or gynaecologist at Counties Manukau Health from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018 during which the Smith & Nephew PICO negative pressure wound therapy system was introduced.
Interventions
Prophylactic use of the Smith & Nephew PICO negative pressure wound therapy system following open obstetric and gynaecological abdominal surgery in patients deemed high risk for developing surgical wound infection by the following criteria:
- Body mass index greater than or equal to 40 or
- Body mass index less than 40 plus two or more of the following risk factors: Diabetes, Steroids or Anticoagulants in the last 48 hours, Autoimmune disorders, Blood or haematological disorders, Immunosuppress
Prophylactic use of the Smith & Nephew PICO negative pressure wound therapy system following open obstetric and gynaecological abdominal surgery in patients deemed high risk for developing surgical wound infection by the following criteria: - Body mass index greater than or equal to 40 or - Body mass index less than 40 plus two or more of the following risk factors: Diabetes, Steroids or Anticoagulants in the last 48 hours, Autoimmune disorders, Blood or haematological disorders, Immunosuppressant medication, Hypertensive disorders, Multiple laparotomies greater than or equal to 3, Previous wound infections, Pre-existing skin problems, Premature Rupture of Membranes, Preterm Premature Rupture of Membranes with Chorioamnionitis, Suspected or confirmed Chorioamnionitis, Prolonged labour with rupture of membranes and fetal scalp electrode. Medical records of patients readmitted to hospital with surgical wound infection within 30 days of primary open obstetric and gynaecological abdominal surgery will be reviewed retrospectively from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018 during which the Smith & Nephew PICO negative pressure wound therapy system was introduced. i.e. data from 1 Jan 2019 to 31 Aug 2019 is the exposure of interest and will be compared to data from the previous period from 1 Jan 2018 - 31 Aug 2018 before negative pressure wound therapy was in use. The total population analysed will consist of approximately 2900 women, but only a high risk (approximately 20%) subset should receive the Smith & Nephew PICO negative pressure wound therapy system. The PICO dressing will be placed by the surgeon at the conclusion of the abdominal component of each operation.
Sponsors
Counties Manukau Health
Eligibility
Sex/Gender
All
Age
5 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All women undergoing open abdominal surgery where the responsible clinician is an obstetrician or gynaecologist at Counties Manukau Health (CMH) from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018.
Exclusion criteria
Women whose primary surgery was performed outside Women’s Health CMH are excluded.
Outcome results
None listed