Treating emergency laparotomy incisions with negative pressure wound therapy

Abstract Introduction Negative pressure wound therapy to reduce incisional surgical site infections is well established for patients undergoing elective surgery with risk factors for surgical site infections. The recent SUNRISE study found no difference in infections in patients undergoing emergency laparotomy. The planned research will investigate surgical site infections, wound dehiscence and incisional hernias after emergency laparotomy. Method Treating Emergency Laparotomy Incisions with Negative pressure wound therapy (TELIN) will be a pragmatic, randomised trial in adults undergoing emergency laparotomy with primary closure at six sites in Sweden. 720 patients will be randomised 1:1 to the standard dressing or negative pressure wound therapy after closure of the emergency laparotomy incision. The wound will be assessed at 7 and 30 days. The patients will answer a survey on quality of life and scar satisfaction survey at 30 days and 1 year, and be offered a CT scan after 1 year to investigate occult hernias. The primary outcome is wound complications, secondary outcomes include wound dehiscence, hernia formation, quality of life and cost-benefit analysis for the first 30 days of care. Result None to report. Discussion TELIN is a multicentre randomised controlled trial that aims to investigate negative pressure wound therapy for closed emergency laparotomy incisions in a low prevalence setting. The hypothesis is that negative pressure wound therapy decreases surgical site infections, decrease wound dehiscence, is well-tolerated by patients and is cost-efficient.