Skip to main content

Advertisement

SpringerLink
Log in

Negative pressure therapy for stoma closure sites—a nonrandomised case control study

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Aim

The PICO (Smith & Nephew, UK) dressing is a single use negative pressure wound therapy (NPWT) system that is designed to be used for up to 7 days for closed wounds. We aimed to assess its use for stoma closure wounds.

Method

We conducted a retrospective analysis of stoma reversal wounds from April 2018 to June 2019. The wound was partially closed with an absorbable subcutaneous suture in a purse-string fashion. A 15 cm × 15 cm PICO dressing was applied directly over this wound. A control group who had received partial purse string closure with packing over the same time period was identified. Patients were contacted and information collected using a questionnaire. The primary outcome measure was the number of visits for dressing changes in the community. Further information was collected about length of stay, time to resolution of pain and return to work.

Results

On average, the patients with PICO dressings attended the community nurses 1.9 times. The patients in the PICO group stated it took 1–2 weeks to return to full work/daily activities. The control group averaged attending the community nurse 11.9 times, and 33% had not returned to work/daily activities in 1–2 weeks.

Conclusion

Those who had a PICO dressing required fewer visits to the community nurse and the majority were able to return to work or resume usual activities within 1 to 2 weeks. This pilot study suggests that negative pressure dressings may be a useful aid for stoma closure site wounds.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Miller C (2013) The history of negative pressure wound therapy (NPWT): from “Lip Service” to the modern vacuum system. J Am Coll Clin Wound Spec 4(3):61–62

    Article  Google Scholar 

  2. Kim S, Kang SI (2020) The effectivness of negative-pressure wound therapy for wound healing after stoma reversal: a randomised control study (SR-PICO study). Trials 22–24

  3. Lee T, Marquez TT, Clerc D, Gie O, Demartines N, Madoff RD et al (2014) Pursestring closure of the stoma site leads to fewer wound infections: results from a multicenter randomized controlled trial. Dis Colon Rectum 57:1282–1289

    Article  Google Scholar 

  4. Camacho-Mauries D, Rodriguez-Diaz JL, Salgado-Nesme N, Gonzalez QH, Vergara-Fernandez O (2013) Randomized clinical trial of intestinal ostomy takedown comparing pursestring wound closure vs conventional closure to eliminate the risk of wound infection. Dis Colon Rectum 56:205–211

    Article  Google Scholar 

  5. Smith and Newphw (2018) Smith-Newphw.com. 15 April 2020. 1. https://www.smith-nephew.com/key-products/advanced-wound-management/pico/pico-7/

  6. National Institute for Health and Care Excellence (2019) NICE.org.uk. 5 April 2020. 1. https://www.nice.org.uk/guidance/mtg43/resources/pico-negative-pressure-wound-dressings-for-closed-surgical-incisions-pdf-64372054098373

  7. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  Google Scholar 

  8. Morykwas MJ, Argenta LC (1997) Classification of surgical complications a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Plast Surg 38(6):563–577

    Article  Google Scholar 

  9. Sinha K, Chauhan VD, Maheshwari R, Chauhan N, Rajan M, Agrawal A (2013) Vacuum assisted closure therapy versus standard wound therapy for open musculoskeletal injuries. Adv Orthop 2013:245940

    Article  Google Scholar 

  10. Malmsjö M, Huddleston E, Martin R (2014) “Biological effects of a disposable, canisterless negative pressure wound therapy system.” Malmsjö M, Huddleston E, Martin R. Biological effects of a disposable, canisterless negative pressure wound therapy system. Eplasty 14:e15 Published 2014 Apr 2. 14 (2014): 15

    PubMed  PubMed Central  Google Scholar 

  11. Karlakki S, Brem M, Giannini S, Khanduja V, Stannard J, Martin R (2013) Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery: a review of evidence and mechanisms for an emerging indication. Bone Joint Res 2(12):276–284

    Article  CAS  Google Scholar 

  12. O'Leary DP, Peirce C, Anglim B, Burton M, Concannon E, Carter M, Hickey K, Coffey JC (2017) Prophylactic negative pressure dressing use in closed laparotomy wounds following abdominal operations: a randomized, controlled, open-label trial: the P.I.C.O. trial. Ann Surg 2017(265):1082–1086

    Article  Google Scholar 

  13. Huang C, Leavitt T, Bayer LR, Orgill DP (2014) Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 51:301–331

    Article  Google Scholar 

  14. Cantero R, Rubio-Perez I, Leon M, Alvarez M, Diaz B, Herrera A, Diaz-Dominguez J, Rodriguez-Montes JA (2016) Negative-pressure therapy to reduce the risk of wound infection following diverting loop ileostomy reversal: an initial study. Adv Skin Wound Care 29:114–118

    Article  Google Scholar 

  15. Poehnert D, Hadeler N, Schrem H, Kaltenborn A, Klempnauer J, Winny M (2017) Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy. Wound Repair Regen 25(6):994–1001

    Article  Google Scholar 

  16. van der Valk M, de Graaf E, Doornebosch P, Vermaas M (2017) Incisional negative-pressure wound therapy for perineal wounds after abdominoperineal resection for rectal cancer, a pilot study. Adv Wound Care 6:425–429

    Article  Google Scholar 

  17. Rondelli F, Franco L, Balzarotti Canger RC, Ceccarelli G, Becattini C, Bugiantella W (2018) Purse-string closure versus conventional primary closure of wound following stoma reversal: meta-analysis of randomized controlled trials. Int J Surg 52:208–213

    Article  Google Scholar 

  18. Hajibandeh S, Hajibandeh S, Kennedy-Dalby A, Rehman S, Zadeh RA (2018) Purse-string skin closure versus linear skin closure techniques in stoma closure: a comprehensive meta-analysis with trial sequential analysis of randomised trials. Int J Color Dis 33(10):1319–1332

    Article  Google Scholar 

  19. Goodman C, Daves SL, Gordon AL, et al (2017) Health services and delivery research: optimal NHS service delivery to care homes: a realist evaluation of the features and mechanisms that support effective working for the continuing care of older people in residential settings. NIHR J Libr

  20. Griffths B, Pagnamenta F, Clark M (2020) Prevena incision managment system for closed surgical incisions.” 28 Februrary 2019. Natl Instit Health and Care Excell

  21. McCluskey P, Brennan K, Mullan J, Costello M, McDonagh D, Meagher H, McLoughlin G, Moloney H, Styche T, Murdoch J (2020) Impact of a single-use negative pressure wound therapy system on healing. J Commun Nurs 34:1

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Ashford and St Peter’s NHS Trust, Surrey, UK

    N. Obeid, E. Sharma, M. Dunstan, P. Nisar, P. Trivedi, R. Madani, H. J. Scott, J. P. Trickett, P. E. Bearn & G. P. Thomas

Authors
  1. N. Obeid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Dunstan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Nisar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Trivedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Madani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. J. Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. P. Trickett
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P. E. Bearn
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. G. P. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Obeid.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

Not applicable

Consent to participate

Not applicable

Consent for publication

Not applicable

Code availability

Not applicable

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

What does this paper add to the existing literature?

It suggests that negative pressure dressings may be a useful aid for stoma closure site wounds. This has not been documented in the literature.

Appendix

Appendix

Table 1 Demographic of patients with traditional purse-string and packing method of closure
Full size table
Table 2 Demographics of patient who were closed using the PICO approach
Full size table
Table 3 Length of stay for patients with a PICO dressing
Full size table
Table 4 Length of stay for patients with the traditionally packing method
Full size table
Fig. 1
figure 1

Attendance to practice nurse for dressing change

Full size image
Fig. 2
figure 2

return to work/daily activities

Full size image
Fig. 3
figure 3

resolution of pain

Full size image
Fig. 4
figure 4

Clavien-Dindo classification

Full size image

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Obeid, N., Sharma, E., Dunstan, M. et al. Negative pressure therapy for stoma closure sites—a nonrandomised case control study. Int J Colorectal Dis 36, 161–167 (2021). https://doi.org/10.1007/s00384-020-03749-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-020-03749-x

Keywords

Search

Navigation