Smith&Nephew

Abstract:

Surgical site complications (SSC) negatively affect costs of care and prolong length of stay. Crohn’s disease (CD) is a risk factor for SSC. CD patients often need surgery, sometimes requiring stoma. Our primary aim was to compare the effects on SSC of a portable device for NPWT (PICO, Smith & Nephew, London, UK) with gauze dressings after elective surgery for CD. Secondary aims were manageability and safety of PICO and its feasibility as home therapy. Between 2010 and 2012, 50 patients were assigned to treatment with either PICO (n = 25) or conventional dressings (n = 25). Each patient completed 12-month follow-up. Parameters of interests for primary aim were SSC, surgical complications, and readmission rates. Data on difficulties in managing PICO and device-related complications were also collected. Patients receiving PICO had less SSC, resulting in shorter hospital stay. At last follow-up, readmission rates were lower with PICO. No differences were observed in surgical complications between groups. No patients reported difficulties in managing the device. Among patients discharged with PICO, none needed to come back to the hospital for device malfunctioning or inability to manage it. PICO reduces SSC and length of stay in selected CD patients compared with conventional dressings. The device is safe and user friendly.

Authors:

Francesco Selvaggi, MD, EBSQ colo, Associate Professor of General Surgery, Unit of General Surgery, Second University of Naples, Naples, Italy, Gianluca Pellino, MD, Resident in General Surgery, Unit of General Surgery, Second University of Naples, Naples, Italy, Guido Sciaudone, MD, PhD, Researcher in General Surgery, Unit of General Surgery , Second University of Naples, Naples, Italy, Angela Della Corte, MD, General Surgeon, Unit of General Surgery, Second University of Naples, Naples, Italy, Giuseppe Candilio, MD, Resident in General Surgery, Unit of General Surgery, Second University of Naples, Naples, Italy, Ferdinando Campitiello, MD, General Surgeon, Unit of General Surgery, Second University of Naples, Naples, Italy, Silvestro Canonico, MD, Full Professor of General Surgery, Unit of General Surgery, Second University of Naples, Naples, Italy

PMID:  24700216

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