15 Negative pressure wound therapy (NPWT) in the management of complicated surgical infections

Abstract Aim Complicated surgical infections have been associated to high mortality rates and prolonged hospital stay interval worldwide. The aim of the present study was to investigate the safety and effectiveness of negative pressure wound therapy (NPWT) in the management of complicated surgical infections. Methods Patients who presented complicated surgical infections (enteroatmospheric fistulas, dehiscence in wounds with previous synthetic mesh placement, soft tissue necrotic infections) at the 1st Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, and presented postoperative fever were prospectively enrolled from 2021 until 2023. Patients’ demographics, perioperative parameters and indications for NPWT utilization were reported. Results In total, 16 patients were included in the present study and their age range was 42–82 years old. The range of hospital stay interval was 5–23 days and the range of NPWT utilization was 9–84 days. Seven patients presented enteroatmospheric fistula, 6 patients had dehiscence in wounds with previous synthetic mesh placement and 3 patients presented soft tissue necrotic infections that were managed using NPWT. In 4 of 16 patients, an extraperitoneal synthetic mesh had been placed. Two patients died due to multiorgan failure which was not associated to the local management of complicated surgical infection. Conclusions NPWT seemed to be a safe and effective option in the management of complicated surgical infections achieving local wound control and successful wound healing with synthetic mesh preservation.