Improved perineal healing: a comparison of incisional negative pressure wound therapy and conventional gauze dressing after abdominoperineal resection
Yas Hashemi, Sofia Dahlberg, Fredrik Jörgren, Marcus EdelhamreAbstract
Introduction
Abdominoperineal resection (APR) is the standard surgical treatment for low rectal cancer. APR is commonly associated with perineal wound complications, resulting in delayed healing, prolonged hospital stays, and reduced quality of life. Negative pressure wound therapy (NPWT) has been suggested to reduce these complications, but its effectiveness remains uncertain. This study aimed to compare the rate of perineal wound closure after APR in patients treated with closed incision NPWT versus conventional gauze dressing (CGD).
Methods
A retrospective analysis of patients undergoing APR between March 2014 and October 2023 at Helsingborg Hospital, Sweden. Patients were grouped according to postoperative wound management: CGD or NPWT. Perineal wounds were assessed at 14, 30, 90 days and 1 year postoperatively. Wound healing and complications were registered.
Results
Of 148 patients, 29.7 per cent (n = 44) received NPWT and 70.3 per cent (n = 104) received CGD. NPWT was associated with lower rates of open perineal wounds at 14 days (13.6 per cent versus 28.9 per cent), 30 days (22.7 per cent versus 42.3 per cent), and 90 days (6.8 per cent versus 26.0 per cent). In stratified subgroup analysis, NPWT was associated with fewer open perineal wounds at 90 days in patients receiving neoadjuvant short-course radiotherapy (SCRT) (5.9 per cent versus 33.3 per cent), whereas no difference was observed in patients not receiving SCRT.
Discussion
NPWT was associated with faster perineal wound closure overall. The benefit was most pronounced in patients receiving neoadjuvant SCRT, supporting the use of NPWT in this high-risk population.