The Effect of Cold Water on Pain Evaluation During Negative Pressure Wound Therapy Dressing Changes: A Prospective, Randomized Controlled Study

2020 ◽  
pp. 153473462095017
Author(s):  
Suphot Chattinnakorn ◽  
Poonpissamai Suwajo ◽  
Jiraroch Meevassana ◽  
Kasama Nilprapha ◽  
Pornthep Pungrasmi ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Room Temperature ◽  
Negative Pressure Wound Therapy ◽  
Cold Water ◽  
Controlled Study ◽  
Control Group ◽  
Sterile Water ◽  
Wound Therapy ◽  
Randomized Controlled ◽  
Dressing Change

Negative pressure wound therapy (NPWT) is a technique using vacuum dressing to promote wound healing in complicated wound. However, for many patients, the application and removal of the NPWT is source of procedural pain. The authors hypothesized that administering cold sterile water into the NPWT sponge would decrease pain during dressing changes. A prospective randomized controlled study was conducted on 27 patients who were undergoing 81 NPWT wound dressing changes (n = 81) at a single institution between October 2016 and September 2017. Each patient had 3 NPWT dressing changes. Cold sterile water (5.74 °C), room temperature sterile water (26.89 °C), and nothing were randomized and administered in the NPWT tubing into the sponge 10 minutes before changing the dressing in each and every procedure. Pain scores were assessed using a 0 to 10 numeric pain scale. Patients administered with cold water reported less pain than those administered with room temperature sterile water during the dressing change (4 vs 5.67; P < .003), and much less pain than those with nothing instilled before dressing change (4 vs 6.59; P < .001). There is no statistically significant difference in pain score between using the room temperature sterile water group and the control group that instilled nothing (5.67 vs 6.59; P = .065). This study has shown that cold water administered through the suction tubing before the dressing change had a better reduction in pain score than using room temperature sterile water and the control group.

scholarly journals Closed incision negative pressure wound therapy versus conventional dressings following soft-tissue sarcoma excision: a prospective, randomized controlled trial

2021 ◽  
Vol 2 (12) ◽  
pp. 1049-1056
Author(s):  
David W. Shields ◽  
Nima Razii ◽  
James Doonan ◽  
Ashish Mahendra ◽  
Sanjay Gupta
Keyword(s):  
Randomized Controlled Trial ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Controlled Trial ◽  
Control Group ◽  
Wound Therapy ◽  
Randomized Controlled

Aims The primary objective of this study was to compare the postoperative infection rate between negative pressure wound therapy (NPWT) and conventional dressings for closed incisions following soft-tissue sarcoma (STS) surgery. Secondary objectives were to compare rates of adverse wound events and functional scores. Methods In this prospective, single-centre, randomized controlled trial (RCT), patients were randomized to either NPWT or conventional sterile occlusive dressings. A total of 17 patients, with a mean age of 54 years (21 to 81), were successfully recruited and none were lost to follow-up. Wound reviews were undertaken to identify any surgical site infection (SSI) or adverse wound events within 30 days. The Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) score were recorded as patient-reported outcome measures (PROMs). Results There were two out of seven patients in the control group (28.6%), and two out of ten patients in the intervention group (20%) who were diagnosed with a SSI (p > 0.999), while one additional adverse wound event was identified in the control group (p = 0.593). No significant differences in PROMs were identified between the groups at either 30 days (TESS, p = 0.987; MSTS, p = 0.951) or six-month (TESS, p = 0.400) follow-up. However, neoadjuvant radiotherapy was significantly associated with a SSI within 30 days of surgery, across all patients (p = 0.029). The mean preoperative modified Glasgow Prognostic Score (mGPS) was also significantly higher among patients who developed a postoperative adverse wound event (p = 0.028), including a SSI (p = 0.008), across both groups. Conclusion This is the first RCT comparing NPWT with conventional dressings following musculoskeletal tumour surgery. Postoperative wound complications are common in this group of patients and we observed an overall SSI rate of 23.5%. We propose proceeding to a multicentre trial, which will help more clearly define the role of closed incision NPWT in STS surgery. Cite this article: Bone Jt Open 2021;2(12):1049–1056.

scholarly journals The effectiveness of negative-pressure wound therapy for wound healing after stoma reversal: a randomised control study (SR-PICO study)

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohyun Kim ◽  
Sung Il Kang
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Intervention Group ◽  
Wound Dressings ◽  
Controlled Study ◽  
Control Group ◽  
Wound Therapy ◽  
Stoma Reversal ◽  
Healing Period

Abstract Background Although the wound-healing period for purse-string closure (PSC) after stoma reversal is longer than that required for the primary closure method, the rate of wound infection is reduced. The application of negative-pressure wound therapy (NPWT) can reduce the healing period for many types of wounds. Herein, we describe a planned trial to test the hypothesis that NPWT can reduce the healing period for PSC after stoma reversal. Methods/design Patients undergoing stoma reversal will be recruited and allocated into intervention and control groups, with 1:1 randomisation. Patients in the control group will receive standard postsurgical wound care; patients in the intervention group will receive NPWT using the PICO™ system. The target sample size will be 38 patients, as this will provide 80% power at the 5% level of significance to detect a 7-day reduction in the wound-healing period in the intervention group compared to that in the control group. The primary endpoint will be the duration to wound healing, defined as the time to nearly complete epithelisation of the wound, without any discharge or surgical site infection (SSI). Secondary endpoints will be the SSI rate, length of postoperative hospital stay, number of wound dressings and visits to the hospital for wound dressing after discharge, total cost of wound dressings, and patient and observer scar assessment scale scores. Discussion The results of this planned randomised controlled study will clarify the role of NPWT in patients undergoing stoma reversal and strengthen the rationale for choosing a dressing technique. Trial registration Clinical Research Information Service (CRIS), KCT0004063. Registered on 6 June 2019.

51 Negative Pressure Wound Therapy for Small-to-medium-sized Paediatric Thermal Burns: A Randomized Controlled Trial (SONATA in C)

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S34-S34
Author(s):  
Cody Frear ◽  
Bronwyn R Griffin
Keyword(s):  
Adverse Events ◽  
Negative Pressure ◽  
Odds Ratio ◽  
Negative Pressure Wound Therapy ◽  
Total Body Surface Area ◽  
Control Group ◽  
Wound Therapy ◽  
Thermal Burns ◽  
Randomized Controlled ◽  
Scar Management

Abstract Introduction In the setting of burns, negative pressure wound therapy (NPWT) has been widely adopted as a means of wound bed preparation prior to skin grafting and graft immobilization. Its role in the treatment of acute burns has been less well-studied, although there is limited evidence to suggest that it might facilitate physiological healing. This study aimed to assess its efficacy in the management of acute burns in children with small-to-medium-sized thermal injuries. Methods In this single-center, two-arm, parallel, randomized, controlled clinical trial, we assigned patients under 17 years of age with acute thermal burns covering &lt; 5% of their total body surface area to either an active control (nanocrystalline silver dressings) or an experimental treatment combining standard dressings with NPWT. Patients were excluded if their burn occurred &gt;7 days prior to presentation, affected the face, or was deemed by clinicians to be trivial. The primary outcome was time to re-epithelialization. Secondary outcomes included scarring, grafting, pain, ease of management, and adverse events. Results A total of 114 children underwent randomization. The median time to re-epithelialization was 8 days (interquartile range (IQR) 7–10) for the NPWT group and 10 days (IQR 8–12.25) for the control group (hazard ratio, 1.515; 95% confidence interval (CI) 1.003 to 2.289; P=0.048). Children administered NPWT within 48 hours of their injury (n=16) re-epithelialized in a median of 7 days (IQR 5–8; HR, 2.129; 95% CI 1.155 to 3.922; P=0.015). The proportion of children referred to scar management was 8.7% for the experimental group and 25.9% for the control group (odds ratio, 0.27; 95% CI 0.08 to 0.90; P=0.032). There were no significant differences in grafting (2.2% vs. 7.4%; odds ratio, 0.28; 95% CI 0.03 to 2.58; P=0.260), pain during dressing changes (P=0.946), or at-home pain between dressing changes (P=0.592). NPWT was associated with a greater treatment burden (P&lt; 0.001) and incidence of adverse events, which included minor blistering and wound maceration. Conclusions In children with small-to-medium-sized thermal burns, NPWT accelerated re-epithelialization and decreased the need for long-term scar management. Applicability of Research to Practice This study found NPWT to be a promising adjunct to standard care in the treatment of pediatric thermal burns. (Clinical Trials Registry number, ACTRN12618000256279.)

scholarly journals Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Frank W. Brennfleck ◽  
Lena Linsenmeier ◽  
Henrik H.G. Junger ◽  
Katharina M. Schmidt ◽  
Jens M. Werner ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Control Group ◽  
Complication Rates ◽  
Site Infection ◽  
Wound Therapy ◽  
Randomized Controlled ◽  
Incisional Ssis

Abstract Background Incisional surgical site infections (iSSI) in hepatopancreatobiliary (HPB) surgery usually lead to prolonged hospital stays, consume valuable resources, and impact on patients’ outcome. Prophylactic closed incision negative pressure wound therapy (ciNPWT) to decrease wound complications has become available. Owing to an increasing number of studies, evidence for superiority in many indication areas has accumulated; however, in general surgery, there are a few data and those have shown contradictory results. Methods In this monocentric, prospective, randomized, controlled, two-armed study, the influence of ciNPWT on incisional surgical site infection rates after HPB operations will be investigated. A total of 222 patients will be randomized 1:1 to an interventional group (7-day treatment with ciNPWT) or a control group (treated with gauze dressing). The primary parameter to evaluate efficacy is the rate of incisional SSIs within 30 days after surgery. Additionally, several clinically relevant secondary outcomes will be assessed. Discussion A reduction in the rate of incisional SSIs would not only lead to a significant cost reduction and shorter postoperative length of stay, but may also improve postoperative quality of life for patients. While earlier publications have shown advantages for ciNPWT, recent studies did not confirm a positive effect regarding iSSI rate. Even if iSSI rate is not reduced, findings obtained from the secondary endpoints may be of clinical relevance, such as reduction of wound complication rates. Trial registration This trial has been registered in the German Clinical Trials Register, DRKS 00015136. Registered on 19 February 2019 and has been approved by the local ethics committee of the University of Regensburg: 18-1225-101.

scholarly journals Reducing Surgical Site Infection with Negative-Pressure Wound Therapy After Open Abdominal Surgery: A Prospective Randomized Controlled Study

2016 ◽  
Vol 106 (3) ◽  
pp. 189-195 ◽  
Author(s):  
P.-Y. Li ◽  
D. Yang ◽  
D. Liu ◽  
S.-J. Sun ◽  
L.-Y. Zhang
Keyword(s):  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Controlled Study ◽  
Control Group ◽  
Site Infection ◽  
Wound Therapy ◽  
Infection Incidence ◽  
Surgical Site Infection Incidence

Background and Aims: Surgical site infection, in particular superficial incision infection, is a common type of complication following abdominal surgery. Negative-pressure wound therapy has been confirmed to reduce the incidence of surgical site infection in various surgeries, but there are few prospective randomized studies into its application to abdominal surgery. Material and Methods: A prospective randomized controlled study was conducted in which patients with abdominal surgery and open surgery were randomly divided into a negative-pressure wound therapy experimental group and a gauze-covering control group. Information about demographic data, type of surgery, surgical sites, incision treatment outcomes, surgical site infection factors, and follow-up was recorded. Results: From May 2015 to December 2015, 71 patients were enrolled in this study, including 33 in the experimental group and 38 in the control group. There were 10 cases of incision complications, all superficial infections, with an incidence of 14.1%. The surgical site infection incidence was statistically different between the experimental and control groups (3.0% vs 23.7%, p = 0.031). Multivariate logistic regression analysis showed that incision length ⩾20 cm increased the surgical site infection incidence (odds ratio value of 15.576, p = 0.004) and that the application of negative-pressure wound therapy reduced the surgical site infection incidence (odds ratio value of 0.073, p = 0.029). Conclusion: Negative-pressure wound therapy can reduce the incidence of surgical site infection in open abdominal surgery.

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