The purpose of this study was to compare the prevalence of surgical site infection (SSI) between children whose umbilical incision was covered with a negative pressure or conventional dressing following laparoscopic surgery.Background
Covering surgical incisions provides reinforcement to wound closures, a surface to absorb exudate, and a barrier against bacteria to prevent SSIs. A conventional practice for laparoscopic procedures is to cover umbilical incisions with adhesive strips and/or surgical glue. Postoperative SSI is common and can lead to slowed healing and poor outcomes. Negative pressure dressings applied postsurgically may prevent infection by providing a better barrier to bacteria. However, there is limited data available to indicate which umbilical incision dressings are associated with fewer SSIs.Design
This study used a retrospective comparative design.Sample/Setting
Following institutional review board approval, the electronic medical records of 486 children, with mean age of 11.7 years, ranging from 1 month to 20 years, 58% male, 84% White race, and who had a laparoscopic appendectomy in a large medical center, were queried.Procedures
Documentation of postoperative SSI, age, race, gender, BMI, laparoscopic procedure, and umbilical or periumbilical incision information was collected and analyzed.Findings
Ten patients acquired SSI; the rate was not statistically significant. Those with vacuum dressings were more likely to have single port laparoscopic appendectomy and a transumbilical incision. There were no statistically significant correlations among the other variables.Implications
Although preventing SSI is important, in this sample few infections were found. Therefore, a simple umbilical vacuum dressing offers a safe and attractive alternative to conventional postoperative dressings.