Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on Deep Surgical Site Infection After Surgery for Lower Limb Fractures Associated With Major Trauma: The WHIST Randomized Clinical Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(7):8 JAMA. 2020 Feb 11;323(6):519-526.What this means for my practice?
Study findings suggest that incisional negative pressure wound therapy does not significantly reduce the risk of deep surgical wound infection, nor does it lead to significantly improved functional or quality of life outcomes, compared to standard wound dressing. However several patients did not receive the randomized treatment and the event rate of deep surgical wound infection was lower than initially expected, which are limitations of the study and causes of concern when interpreting the data.
Study Summary
One thousand five hundred and forty-eight patients presenting with a lower extremity fracture caused by major trauma received surgical intervention followed by surgical wound dressing with an incisional negative pressure wound therapy (iNPWT) device or with standard sterile dressing. The primary outcome of interest was the incidence of deep surgical site infection within the first 30 days post-operation. Secondary outcomes of interest included the Disability Rating Index (DRI), the EQ-5D quality of life measure, EQ-5D on a Visual Analog Scale (VAS), the patient and observer scar assessment scale, and the incidence of chronic neuropathic pain as determined by the Douleur Neuropathique Questionnaire. Results revealed no significant differences between the iNPWT and standard groups in all outcomes.
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