The Effect of Prophylactic Negative Pressure Wound Therapy Compared With Standard Methods of Laparotomy Wound Closure in Patients Who Underwent Open Surgery for Colorectal Cancer

Resume. Wound therapy with negative pressure, since its inception, has gained more and more indications for its use and includes the prevention of infectious complications in the field of surgical intervention. The aim of the study. Comparative analysis of methods of primary closure of the laparotomy wound in patients who underwent open surgery for colorectal cancer. Research materials and methods. The research used the results of treatment of 32 patients with colorectal cancer, who were treated in the oncosurgical department of the abdominal organs of the «OCO» KNP. Inclusion criteria were as follows: presence of colorectal cancer; absence of metastasis; surgical intervention was carried out by an open method; lack of perioperative special treatment; the presence of concomitant pathology, such as: diabetes, coronary heart disease and the presence of risk factors BMI ≥ 35, BMI ≤ 19, smoking. The patients were divided into two groups: the main group I (16 patients), - the patients underwent preventive therapy of wounds with negative pressure, and the II comparative group (16 patients), - the patients were treated using classical methods. Patients of both groups received infusion and prophylactic antibiotic therapy for up to 3 days; bacterial cultures were taken from subcutaneous adipose tissue immediately before suturing the wound, or before applying a VAC bandage and in the event of purulent complications. Research results and their discussion. In the main group, after installation and removal of the VAC bandage, the level of pro-inflammatory markers remained almost unchanged. At the same time, the comparison group had a higher level of pro-inflammatory markers on the third day with a tendency to decrease by the 7th day. But 5 (31.25%) patients developed a postoperative complication on the 3rd- 4th day — seroma of the postoperative wound, in 2 (12.5%) of them, it was complicated by the addition of an infection. Thus, based on the obtained data, it is possible to assume that prophylactic therapy with negative pressure leads to a decrease in postoperative complications. Conclusions. Taking into account the results of the study, it can be assumed that the prevention of complications of postoperative wounds has its advantages, it reduces the risk of infectious complications, reduces the risk of repeated surgical interventions, and reduces additional costs due to a long stay in the hospital. Preventive negative pressure therapy can be considered as a part of effective and cost-effective medical care and not only that.