PROPHYLACTIC CLOSED INCISION MANAGEMENT BY NEGATIVE PRESSURE THERAPY

Global Wound Care Congress

September 12-13, 2016 San Antonio, USA

Onnen Grauhan

Deutsches Herzzentrum Berlin, Germany

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Surgical Site Infections (SSI) affect 3%-6% of patients undergoing Cardiothoracic surgery; however, in high-risk subgroups (obesity, diabetes) infection rate may rise to 20%. The key event in most SSI (60%-80%) is caused by the skin suture breakdown and subsequent seepage of germs into deeper tissue layers. Due to delayed (secondary) wound healing, i.e. delayed establishment of an effective anti-microbacterial barrier, Surgical Site Infections (SSI) occur up to 90 days after wound closure. The concept of (prophylactic) closed incision management of negative pressure therapy (ciNPT) consists in 1) preserving a protected (low-germ) wound environment by an occlusive dressing for several days and 2) supporting accelerated wound healing by drainage of wound secretions, improved microcirculation and lymph drainage as well as by stable approximation of incision edges (shear stress reduction). In this way an effective anti-microbacterial barrier is already acquired after 7 to 8 days, even in problem zones (e.g. incision crossing the submammary fold). During the past years we have investigated (prophylactic) closed incision management by negative pressure therapy (ciNPT) in (obese) high-risk patients as well as in an â�?�?all-comersâ�? population and have found a reduction of SSI requiring surgical intervention from 16.0% to 4.0% and 3.4% to 1.3%, respectively. In the meantime, these results have been confirmed by many surgeons from other disciplines and recently an International Multidisciplinary Consensus Conference recommended that â�?�?surgeons assess patientsâ�?�? individual risk factors and type of surgery and consider using ciNPT for individuals at high risk for developing SSI or for those undergoing a high-risk operative procedure.â�?

Biography :

Email: grauhan@dhzb.de