Prophylactic Negative Pressure Wound Therapy to Prevent Surgical Site Infection after Emergency Laparotomy

ABSTRACT: Background: Surgical site infections (SSI) following emergency laparotomy remain a significant source of postoperative morbidity. Prophylactic Negative Pressure Wound Therapy (NPWT) has emerged as a promising intervention to reduce incidence of SSIs, especially in high-risk wounds. This study aimed to compare NPWT with conventional dressing in preventing SSIs and improving woundrelated outcomes after emergency abdominal surgery. Methods: In a single centre randomized controlled trial, 56 adult patients undergoing emergency laparotomy for acute abdomen were allocated to receive NPWT or betadine gauze dressing. Wounds were assessed postoperatively on days 4 and 30 for SSI, seroma, hematoma, and length of hospital stay. Results: The rate of superficial SSI on postoperative day 4 was significantly lower in the NPWT group compared to the control group (3.6% vs. 21.4%, p = 0.043). At day 30, SSI remained lower in the NPWT group (7.1% vs. 25%, p = 0.06). No patients in the NPWT group developed deep SSI, seroma, or hematoma. Hospital stay was significantly shorter in the NPWT group (mean 9.68 days vs. 12.18 days; p = 0.005). Conclusion: NPWT significantly reduced early superficial SSIs and decreased hospital stay compared to conventional dressing. It is an effective and safe prophylactic strategy following emergency laparotomy, particularly in contaminated wounds.