- Academic Editor
-
-
-
Background: Endometrial cancer is the most common gynaecological cancer
and has a strong association with obesity. Surgical site infection (SSI) carries
high morbidity and is more frequent in obese patients. Closed incision negative
pressure wound therapy (ciNPWT) has been proposed to reduce wound morbidity but
is more expensive than standard dressings whilst the evidence has been very
heterogenous. There is limited evidence to justify this expensive dressing as
related to its effectiveness in gynaecological oncology patients. ciNPWT was
introduced in New Zealand in 2017 based on the available evidence from studies on
SSI in the obstetric population. The aim of this study is to investigate the rate
of SSI in patients with endometrial carcinoma undergoing laparotomy using
standard surgical dressings compared to ciNPWT. Methods: We performed a
retrospective analysis of 170 patients who underwent a laparotomy for endometrial
carcinoma between 2018 and 2019 across three hospitals in New Zealand after the
introduction of ciNPWT. Dressings were applied according to individual surgeons’
preferences. Standard dressings and ciNPWT were compared in the occurrence of
SSI, wound dehiscence, readmission and return to theatre rates using logistic
regression in order to account for potential confounding due to the patient
demographics and oncologic and surgical characteristics. Results: There
were 129 patients in the standard dressing group and 41 patients in the ciNPWT
group. The mean age was 60.4 years (range 25–86). The mean body mass index (BMI)
was 38.2 kg/m