Clinical evaluation of the method of vacuum therapy in the complex treatment of infected postoperative wounds of the anterior abdominal wall

• Cherkasov M.F.
• Cherkasov D.M.
• Melikova S.G.
• Startsev Yu.M.
• Galashokyan K.M.
• Endorenko K.V.

Abstract

Background. Wound complications after surgical interventions represent a serious problem both for patients and for the healthcare system as a whole, and require improved approaches to their treatment.

Aim. Improving the results of complex treatment of patients with infected postoperative wounds of the anterior abdominal wall using vacuum therapy.

Material and methods. At the Rostov State Medical University, 39 patients with infected postoperative wounds of the anterior abdominal wall were treated using of vacuum therapy as a part of complex treatment. The control (retrospective) group of the study consisted of 32 patients who used traditional wound treatment. Following parameters were assessed: clinical healing, planimetric indicators, data from microbiological examination of the wounds, laboratory parameters, preservation/removal of the mesh implant, average bed day.

Results. The rate of wound healing with vacuum therapy was significantly higher and amounted to 2.7±0.45 cm²/day. Patients in the main group showed a more rapid decrease in microbial contamination of wounds. By the 4^th day of treatment, there was a clear tendency towards a decrease in the number of blood leukocytes in patients of the main group compared to the control group. The average of vacuum therapy 21.7±2.35 days. No complications of vacuum therapy were identified. In the main group, repeated surgical/interventions were not required; in all patients, mesh implants were preserved after allohernioplasty. The length of stay in the hospital for patients in the main group was 18.5±7.6 days, which is significantly less than in the control group – 23.2±8.4 days. Complete wound healing was 29.1±0.35 days in the main group and 47.3±1.24 days in the control group.

Conclusion. Vacuum therapy has a pronounced positive effect on tissue regeneration processes. The use of local negative pressure helps to quickly relieve inflammation and cleanse infected wounds, leads to a significant reduction in the time of complete healing and disability, and reduces the cost of hospital treatment. Vacuum therapy in combination with instillation in patients with infected wounds after allohernioplasty increases the possibility of preserving mesh implants.

Keywords: infected postoperative wound; surgical site infections; anterior abdominal wall; mesh infection; vacuum therapy; negative pressure wound therapy

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