Effectiveness Of Closed Incision Negative Pressure Therapy Compared To Conventional Moist Dressing After Laparotomy For Peritonitis: A Randomized Controlled Trial

Abstract

Postoperative wound complications following laparotomy for peritonitis remain a significant challenge in surgical practice. Among the interventions aimed at optimizing wound healing, Closed Incision Negative Pressure Therapy (CINPT) and Conventional Moist Dressing (CMD) are commonly used techniques. However, the superiority of one over the other has remained inconclusive.

Objective: To evaluate and compare the efficacy of CINPT and CMD in improving wound healing outcomes following laparotomy for peritonitis.

Methods: A randomized controlled trial was conducted at the Department of Surgery, Jinnah Hospital, Lahore, from June 30, 2021, to January 1, 2022. A total of 60 patients undergoing laparotomy for peritonitis were randomly assigned into two groups (n=30 each). Group A received CINPT, while Group B was managed with CMD. Wound healing was assessed in terms of wound dehiscence, infection rate, and hospital stay. Dressings in Group A were changed every 72 hours; in Group B, every 24 hours. Data were recorded on a standardized proforma and analyzed using appropriate statistical tools.

Results: Wound dehiscence occurred in 6.7% of patients in the CINPT group compared to 26.7% in the CMD group. Similarly, wound infection was observed in 6.7% of CINPT patients and 26.7% of CMD patients. The average duration of hospital stay was shorter in the CINPT group, with 93.3% of patients discharged by day 7, compared to 13.3% in the CMD group. The difference was statistically significant (p=0.025).

Conclusion: CINPT significantly reduces wound complications and shortens hospital stay when compared to CMD following laparotomy for peritonitis. These findings support the adoption of CINPT as a standard practice in surgical wound care protocols for peritonitis cases.