Xu DY, Bai BJ, Shan L, Wei HY, Lin DF, Wang Y, Wang D. Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure. World J Gastrointest Surg 2024; 16(1): 186-195 [PMID: 38328332 DOI: 10.4240/wjgs.v16.i1.186]
Corresponding Author of This Article
Da Wang, MD, Professor, Department of Colorectal Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. 3204004@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2024; 16(1): 186-195 Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.186
Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure
Deng-Yong Xu, Bing-Jun Bai, Lina Shan, Hui-Yan Wei, Deng-Feng Lin, Ya Wang, Da Wang
Deng-Yong Xu, Bing-Jun Bai, Lina Shan, Deng-Feng Lin, Da Wang, Department of Colorectal Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Hui-Yan Wei, Department of Wound & Ostomy Care Clinic, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Ya Wang, Department of Hospital Infection Control, Zhejiang Cancer Hospital, Hangzhou 310005, Zhejiang Province, China
Author contributions: Xu DY and Bai BJ were responsible for the study conception and design; Shan LN and Wei HY analyzed the data and wrote the manuscript; Lin DF, Wang Y, and Wang D critically revised the article for important intellectual content; all the authors reviewed and approved the final version to be published.
Supported bythe Zhejiang Provincial Natural Science Foundation of China, No. LQ20H260002.
Institutional review board statement: The study was reviewed and approval by the Ethics Committee of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University (No. 20191217-9).
Clinical trial registration statement: The trial was registered at Chinese Clinical Trial Registry at https://www.chictr.org.cn (registration number: ChiCTR2200064827).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no potential conflicting interests related to this paper.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da Wang, MD, Professor, Department of Colorectal Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. 3204004@zju.edu.cn
Received: August 22, 2023 Peer-review started: August 22, 2023 First decision: November 20, 2023 Revised: November 30, 2023 Accepted: December 13, 2023 Article in press: December 13, 2023 Published online: January 27, 2024 Processing time: 156 Days and 1.8 Hours
ARTICLE HIGHLIGHTS
Research background
Although ileostomy closure is technically easy, it is associated with a non-negligible overall morbidity rate (11%-37%), with incisional surgical site infection (SSI) being the most common.
Research motivation
The incisional SSI rate after ileostomy closure is much higher than those of other intestinal surgeries, ranging from 2% to 40%. Incisional SSI is responsible for increased pain, longer hospital stays, and higher treatment costs. Current methods for incisional SSI prevention have limitations. Finding a new approach to prevent incisional SSI is urgent for patients receiving ileostomy closure.
Research objectives
Micro-power negative pressure wound technique (MPNPWT) contains a special material that produces micro-negative pressure by absorbing exudates rather than suction device. It reduces wound edema and stimulates epithelial cell proliferation and granulation tissue growth, thus shortening wound healing time. This study aimed to evaluate the efficacy and safety of MPNPWT in preventing incisional SSI. The results of our study will provide foundation for future application of MPNPWT.
Research methods
This was a single-center, prospective, randomized controlled trial (RCT). An independent statistician randomly assigned eligible patients in a 1:1 ratio using sequentially sealed envelopes to a control group or an MPNPWT group without stratification. Micro-power negative pressure dressing was filled on the skin surface of patients in the MPNPWT group by nurses from wound care clinic.
Research results
MPNPWT significantly reduced incisional SSI rate (2.0%). MPNPWT is a safe technique without any side effect. MPNPWT could also help heal the infected incision.
Research conclusions
Our study introduces a novel technique, MPNPWT, to prevent incisional SSI after loop ileostomy closure. MPNPWT reduces the incidence of incisional SSI after loop ileostomy closure.
Research perspectives
A larger RCT with a larger sample is the direction of the future research.
