Dr. Vincenzo Vigorita

The Use of NPWT for the Prevention of SSI in Colorectal Surgery

Surgical site infections are amongst the most feared post-operative complications and are also very frequent in surgery; they account for approximately 20% of all healthcare-associated infections in Europe. Despite the implementation of evidence-based prevention measures, the incidence of superficial surgical wound infections after colorectal surgery is the highest in abdominal surgery, occurring in 15-30% of patients. There are many factors that increase the incidence of SSI; they are obesity, male sex, diabetes, ASA greater than three, creation of a stoma, intraoperative complications, perioperative transfusions, and surgical times longer than 180 minutes, while laparoscopy was a protective factor against the incidence of surgical site infections. Single-use negative pressure therapy has been shown to increase the effectiveness of lymphatic blood and reduce edema and protect incisions from external contamination, help the activity of the lymphatic system with deep tissues, maintain effective blood supply, maintain the incision in place, and reduce lateral tension, as well as increase lymphatic drainage, reduce edema and reduce seroma and hematoma. In the last few years, the number of unicentric and multicentric studies on the prophylactic use of negative pressure therapy in colorectal surgery has increased, and the results highlight how this strategy can reduce the incidence of surgical site infections, the costs and the length of stay compared to the use of conventional dressings in patients who underwent colorectal surgery. In this presentation, we show a series of clinical cases on the prophylactic use of negative pressure therapy in colorectal surgery.